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Failed Awake Intubation for Critical Airway Obstruction Rescued With the Ventrain Device and an Arndt Exchange Catheter: A Case Report

Morrison, Stuart MBChB, FFARCSI*; Aerts, Sophie MD*; Van Rompaey, Diane MD; Vanderveken, Olivier MD, PhD†‡

doi: 10.1213/XAA.0000000000000975
Case Reports
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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.

Funding: None.

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 stuart.morrison@uza.be.

Copyright © 2019 International Anesthesia Research Society
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