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Korean J Anesthesiol > Epub ahead of print
DOI: https://doi.org/10.4097/kja.d.18.00334    [Epub ahead of print]
Published online February 19, 2019.
Use of a transtracheal rapid insufflation of oxygen device in a 'cannot intubate, cannot ventilate' scenario in a parturient
John Lee1, Von Vee Ng1, Constance Teo2, Patrick Wong1
1Department of Anaesthesiology, Singapore General Hospital, Outram Road, Singapore 169608
2Department of Otolaryngology, Singapore General Hospital, Outram Road, Singapore 169608
Corresponding author:  John Lee,
Email: john.lee.s.e@singhealth.com.sg
Received: 3 November 2018   • Revised: 31 January 2019   • Accepted: 16 February 2019
Abstract
The trans-tracheal rapid insufflation of oxygen [TRIO] device is a less commonly used device that is an alternative to trans-tracheal jet ventilation for maintaining oxygenation in a ‘cannot intubate, cannot oxygenate’ [CICO] scenario. However, it may result in inadequate ventilation which can result in hypercarbia and respiratory acidosis and hence should only be used as a temporizing measure before a definitive airway can be secured. We describe its successful use in maintaining oxygenation after jet ventilator failure in a parturient presenting for an excision of laryngeal papilloma who developed a CICO scenario. A stepwise approach to the airway plan and planning for failure is essential for good materno-fetal outcomes.
Key Words: Insufflation; high-frequency jet ventilation; airway obstruction; airway management; Anaesthesia, obstetrical, Trans-tracheal rapid insufflation of oxygen [TRIO]
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