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TRACHEOTOMY AND ROLE OF LOW POSITIVE PRESSURE VENTILATION DURING PREOXYGENATION IN A PATIENT WITH LARGE LARYNGEAL NEUROENDOCRINE CARCINOMA

SANJA MILOŠEV orcid.org/0000-0003-2701-9919 ; Klinički centar Vojvodine, Klinika za uho, nos i vrat, Klinika za anesteziologiju, Novi Sad, Srbija
VLADIMIR DOLINAJ orcid.org/0000-0002-2092-5479 ; Klinički centar Vojvodine, Klinika za uho, nos i vrat, Klinika za anesteziologiju, Novi Sad, Univerzitet u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija
DRAGANA RADOVANOVIĆ orcid.org/0000-0002-5071-7929 ; Institut za onkologiju Vojvodine,Klinika za operativnu onkologiju, Odjel za anesteziologiju, Novi Sad, Univerzitet u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija
VLADIMIR KLJAJIĆ ; Klinički centar Vojvodine, Klinika za uho, nos i vrat,Odjel za laringologiju, Novi Sad, Univerzitet u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija
NATAŠA MARKOVIĆ orcid.org/0000-0003-0494-0377 ; Opća bolnica Subotica, Klinika za uho, nos i vrat, Odjel za anesteziologiju, Subotica, Srbija
DUŠANKA JANJEVIĆ ; Klinički centar Vojvodine, Klinika za uho, nos i vrat, Klinika za anesteziologiju, Novi Sad, Srbija

Sažetak

Small cell neuroendocrine carcinoma of the larynx is a rare epithelial origin neuroendocrine carcinoma. Its endolaryngeal growth may lead to airway obstruction and consequently endanger patient life. Managing the airway in this case poses great challenge for the anesthesiologist. The aim of this case report is to present alternative airway management in case of the possible unsuccessful endotracheal intubation. Emergency tracheotomy in sedoanalgesia and local anesthesia is successfully performed in patient with large neuroendocrine carcinoma of the larynx. Midazolam and remifentanyl used for sedoanalgesia may lead to respiratory depression. Therefore, pressure support preoxygenation was performed in order to prevent hypoxia, which could occur during the period of apnea. In conclusion, this regimen of preoxygenation prior to tracheotomy in sedoanalgesia and local anesthesia could be an appropriate alternative to general anesthesia and endotracheal intubation, especially in case of large endoluminal tumor that almost completely obstructs the airway.

Ključne riječi

neuroendocrine carcinoma of the larynx; preoxygenation; positive pressure ventilation preoxygenation; tracheotomy

Hrčak ID:

209077

URI

https://hrcak.srce.hr/209077

Datum izdavanja:

18.11.2018.

Podaci na drugim jezicima: hrvatski

Posjeta: 1.438 *