Silva Rita, Carvalho Tania, Tarroso Maria João, Cardoso Helder
Anesthesiology, Centro Hospitalar Tâmega e Sousa, EPE, Penafiel, PRT.
Cureus. 2024 Jan 23;16(1):e52787. doi: 10.7759/cureus.52787. eCollection 2024 Jan.
This report details a challenging case of difficult extubation due to a lodged tracheal tube following surgery, presenting an unexpected and complex clinical situation. An inspection of the airway using videolaryngoscopy revealed an over-inflated cuff beneath the vocal cords. Initial efforts to deflate the cuff with various methods were unsuccessful. The situation was ultimately resolved through the intervention of an otolaryngology surgeon. This case not only reviews various mechanisms of difficult endotracheal tube removal reported in the literature, but also underscores the potential for serious complications and highlights the critical role of multidisciplinary collaboration in managing extubation challenges. Additionally, our manuscript discusses alternative strategies that can be employed in scenarios where an otolaryngology surgeon is not available, offering practical guidance for anesthesiologists confronted with similar situations.
本报告详细介绍了一例因术后气管导管嵌顿导致拔管困难的具有挑战性的病例,呈现了一种意想不到且复杂的临床情况。使用视频喉镜对气道进行检查时,发现声带下方的气囊过度充气。最初尝试用各种方法给气囊放气均未成功。最终通过耳鼻喉科外科医生的干预解决了该问题。该病例不仅回顾了文献中报道的各种困难气管导管拔除机制,还强调了严重并发症的可能性,并突出了多学科协作在应对拔管挑战中的关键作用。此外,我们的手稿讨论了在没有耳鼻喉科外科医生的情况下可采用的替代策略,为面临类似情况的麻醉医生提供了实用指导。