Face-To-Face Double-Lumen Tube Intubation With the Airtraq Video Laryngoscope for Emergency Thoracic Surgery: A Case Report.

IF 1.1 Q3 ANESTHESIOLOGY Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-03-01 Epub Date: 2021-04-12 DOI:10.1177/10892532211007664
Yacine Ynineb, Emilie Boglietto, Francis Bonnet, Christophe Quesnel, Marc Garnier
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引用次数: 3

Abstract

Double-lumen intubation is commonly used for thoracic surgery as it allows rapid and effective one-lung ventilation. However, it is more difficult than single-lumen tube intubation, notably in the context of emergency surgery and/or in hypoxemic patients. We report the case of a 57-year-old patient requiring emergency revision surgery after an upper right lobectomy due to postoperative pneumothorax and pleuropneumonia. As rapid lung isolation was required due to a bronchopleural fistula, rapid sequence induction and double-lumen tube intubation were performed. In addition, as the patient was hypoxemic with incomplete pre-oxygenation and too uncomfortable to tolerate the recumbent position despite high-flow oxygen, intubation was performed in face-to-face position. The patient was successfully intubated in 22 seconds and the right lung immediately isolated, allowing the surgeon to clean the pleural cavity. This is the first report of a double-lumen tube intubation in face-to-face position. The expected difficulties related to this type of intubation were successfully prevented using an Airtraq laryngoscope. Although such a strategy cannot be recommended from this one case, this report is encouraging for future studies evaluating the potential advantages of Airtraq use for double-lumen face-to-face intubation for emergency thoracic surgery.

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急诊胸外科用Airtraq视频喉镜面对面双腔管插管1例。
双腔插管通常用于胸外科手术,因为它可以实现快速有效的单肺通气。然而,它比单腔管插管更困难,特别是在急诊手术和/或低氧血症患者中。我们报告一例57岁的患者,在右上肺叶切除术后因术后气胸和胸膜肺炎而需要紧急翻修手术。由于支气管胸膜瘘需要快速肺隔离,因此进行了快速序列诱导和双腔管插管。此外,由于患者低氧血症且预充氧不完全,且在高流量供氧下仍难以忍受平卧位,因此采用面对面位插管。患者在22秒内成功插管,并立即分离右肺,使外科医生能够清洁胸膜腔。这是首例面对面双腔管插管的报道。使用Airtraq喉镜成功地避免了与这种插管相关的预期困难。虽然这种策略不能从这个病例中推荐,但该报告对未来评估Airtraq用于急诊胸外科双腔面对面插管的潜在优势的研究是令人鼓舞的。
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CiteScore
3.60
自引率
14.30%
发文量
31
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