Anaphylaxis Induced Refractory Bronchospasm in “Anticipated Difficult Airway” Situation: Combined Approach of Fibre Optic Laryngoscope Guided Endotracheal Tube Placement via the Nasal Route and Sevoflurane during Rapid Sequence Induction
We wish to report here how we tackled anaphylaxis-induced bronchospasm in an ‘anticipated difficult airway’ situation using a novel combination of established practices. Our patient was morbidly obese and had both predicted difficult mask ventilation as well as predicted difficult intubation in the...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-07-01
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| Series: | NMO Journal |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/JNMO.JNMO_20_24 |
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| Summary: | We wish to report here how we tackled anaphylaxis-induced bronchospasm in an ‘anticipated difficult airway’ situation using a novel combination of established practices. Our patient was morbidly obese and had both predicted difficult mask ventilation as well as predicted difficult intubation in the immediate pre-induction period. He developed bronchospasm, which we attempted to treat as per the established protocols. All of these failed, and we then proceeded to insert a 7-mm endotracheal tube nasally, its tip lying just above the epiglottis (via fibre-optic guidance). Sevoflurane vapours and oxygen were delivered through it, and this gradually relieved the bronchospasm and improved the patient’s oxygenation. |
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| ISSN: | 2348-3806 2950-5933 |