A 71-year-old man with advanced vocal cord carcinoma presented with severe airway obstruction. Therapeutic anticoagulation with enoxaparin complicated management. Failure of an oral awake bronchoscopic intubation was rescued by passing a guidewire through the working channel and threading an Arndt exchange catheter into the trachea under videoscopic vision. Ventilation with the Ventrain device lasting 40 minutes (15 L/min, inspiration/expiration 1:1, 15 breaths/min), during IV anesthesia with muscle paralysis, resulted in excellent blood gas values until placement of the tracheal cannula. This case report highlights the effectiveness of a novel ventilation technique that should be considered as back-up when bronchoscopic intubation fails.
From the Departments of *Anesthesiology
†Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium
‡Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Accepted for publication December 26, 2018.
The authors declare no conflicts of interest.
Address correspondence to Stuart Morrison, MBChB, FFARCSI, Department of Anesthesiology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium. Address e-mail to firstname.lastname@example.org.