Miyajima Saki, Takahashi Kan, Matsuba Sho
Department of Anesthesiology, Kanazawa Medical University, Ishikawa, JPN.
Cureus. 2024 Dec 23;16(12):e76285. doi: 10.7759/cureus.76285. eCollection 2024 Dec.
Management of difficult airways in the emergency department is challenging. Herein, we report a case of successful management of severe upper airway obstruction caused by angioedema, where intubation was achieved using a dual-function video laryngoscope and bronchoscope system in the emergency department for a patient with severe upper airway stenosis due to angioedema. A 74-year-old obese man with dyspnea presented to our emergency department. Despite initial attempts using a conventional intubation technique, the patient's airway remained difficult to manage because of marked enlargement of the tongue. The anesthesiologists decided to apply the dual-function video laryngoscope and bronchoscope system (GlideScope Core System™, Verathon Inc., Bothell, WA, USA). Finally, nasotracheal intubation was successfully performed using a bronchoscope switched from a video laryngoscope. The patient's respiratory status improved post-intubation. Subsequent management proceeded uneventfully. The patient was transferred to the ICU, where he was diagnosed with angioedema after admission.
急诊科困难气道的管理具有挑战性。在此,我们报告一例成功处理血管性水肿所致严重上气道梗阻的病例,在急诊科,一名因血管性水肿导致严重上气道狭窄的患者使用双功能视频喉镜和支气管镜系统成功插管。一名74岁的肥胖男性因呼吸困难来到我们的急诊科。尽管最初尝试了传统插管技术,但由于舌头明显肿大,患者的气道仍然难以处理。麻醉医生决定应用双功能视频喉镜和支气管镜系统(GlideScope Core System™,美国华盛顿州博塞尔市Verathon公司)。最后,通过将视频喉镜切换为支气管镜成功进行了鼻气管插管。插管后患者的呼吸状况得到改善。随后的处理过程顺利。患者被转入重症监护病房,入院后被诊断为血管性水肿。