Cataldo Rita, Zdravkovic Ivana, Petrovic Zaklina, Corso Ruggero M, Pascarella Giuseppe, Sorbello Massimiliano
Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Università Campus Bio-Medico di Roma, via Álvaro del Portillo 21, Rome, Italy.
Department of Anesthesia and Reanimation, Clinical Hospital Center "Zvezdara", Belgrade, Serbia.
Saudi J Anaesth. 2021 Apr-Jun;15(2):199-203. doi: 10.4103/sja.SJA_902_20. Epub 2021 Apr 1.
Massive hematemesis could be challenging situation requiring emergency airway control and urgent surgical treatment. We report a case of difficult airway management with blind intubation through Laryngeal Mask Airway in a 56-year-old patient with massive hematemesis. After failed endoscopic attempts to stop bleeding, worsening of hemodynamics called for emergency intubation and surgery. After failed intubation attempts and face-mask ventilation worsening, a classic LMA was used for rescue ventilation and decision was made to intubate through LMA. The airway exchange was aided by a nasogastric tube (NGT) through LMA, confirmed with capnography and surgery was started successfully and uneventfully. Unexpected difficult airway can be extremely challenging situation, especially in emergency settings with no possibility to delay surgery. In those cases, literature suggests different intubating techniques through LMA. Blind intubation through LMA aided by NGT showed to be a suitable option in resources-limited settings, where advanced supraglottic devices and/or optical devices are not available.
大量呕血可能是一种具有挑战性的情况，需要紧急气道控制和紧急手术治疗。我们报告一例56岁大量呕血患者，通过喉罩气道进行盲插的困难气道管理病例。在内镜止血尝试失败后，血流动力学恶化需要紧急插管和手术。在插管尝试失败且面罩通气恶化后，使用经典喉罩进行抢救通气，并决定通过喉罩插管。通过经喉罩插入的鼻胃管辅助进行气道交换，通过二氧化碳描记法确认，手术成功且顺利开始。意外的困难气道可能是极具挑战性的情况，尤其是在无法延迟手术的紧急情况下。在这些情况下，文献提出了不同的经喉罩插管技术。在资源有限的环境中，当无法获得先进的声门上装置和/或光学装置时，经鼻胃管辅助经喉罩盲插是一种合适的选择。
