BACKGROUND Fiberoptic bronchoscopic intubation is the gold standard for endotracheal intubation in difficult or compromised airway situations. However, oxygen insufflation through the working channel of a fiberscope i...BACKGROUND Fiberoptic bronchoscopic intubation is the gold standard for endotracheal intubation in difficult or compromised airway situations. However, oxygen insufflation through the working channel of a fiberscope is a controversial method because of the possibility of gastric distention and rupture during an awake fiberoptic bronchoscopic intubation, despite the advantages of preventing fogging of the fiberoptic bronchoscopic lens, blowing oral secretions away, and oxygenation of patients.CASE SUMMARY Here, we describe a case of cervical instability where we rapidly performed fiberoptic bronchoscopic intubation using oxygen insufflation through working channel of the broncoscopy to administer general anesthesia after two previous failures due to low visibility. A 50-year-old man with a non-specific medical history underwent emergency cervical spine surgery for posterior fusion of the C2 and C3 vertebrae. After two unsuccessful attempts at intubation using the fiberoptic broncoscopy, we performed it successfully using the oxygen insufflation via the working channel, instead of using suction to remove the secretion from the lens.CONCLUSION Oxygen insufflation via the working channel of thebroncoscopy is a useful method for assisting with difficult intubation cases.展开更多
基金Supported by clinical research grant from Pusan National University Hospital 2017
文摘BACKGROUND Fiberoptic bronchoscopic intubation is the gold standard for endotracheal intubation in difficult or compromised airway situations. However, oxygen insufflation through the working channel of a fiberscope is a controversial method because of the possibility of gastric distention and rupture during an awake fiberoptic bronchoscopic intubation, despite the advantages of preventing fogging of the fiberoptic bronchoscopic lens, blowing oral secretions away, and oxygenation of patients.CASE SUMMARY Here, we describe a case of cervical instability where we rapidly performed fiberoptic bronchoscopic intubation using oxygen insufflation through working channel of the broncoscopy to administer general anesthesia after two previous failures due to low visibility. A 50-year-old man with a non-specific medical history underwent emergency cervical spine surgery for posterior fusion of the C2 and C3 vertebrae. After two unsuccessful attempts at intubation using the fiberoptic broncoscopy, we performed it successfully using the oxygen insufflation via the working channel, instead of using suction to remove the secretion from the lens.CONCLUSION Oxygen insufflation via the working channel of thebroncoscopy is a useful method for assisting with difficult intubation cases.
