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Can’t Intubate, Can’t Oxygenate: A Rare Case of a Difficult Airway due to Nonhereditary Angioedema

Điđi Delalić ; Medical School, University of Zagreb, Zagreb, Croatia
Vinko Borčić ; Merkur University Hospital, Zagreb, Croatia
Ingrid Prkačin orcid id ; Medical School, University of Zagreb, Zagreb, Croatia; Merkur University Hospital, Zagreb, Croatia

Puni tekst: engleski pdf 1.548 Kb


str. 99-102

preuzimanja: 344



Angioedema is a form of allergic mediated by histamine and non-allergic mediated
by bradykinin and can be lethal if not recognized and treated promptly. This case demonstrates
the proper diagnosis of and intervention in rapid onset severe angioedema.
A 68-year-old male came to the emergency department with a complaint of dyspnea that started
two hours before. He had type II diabetes, chronic kidney disease and several different antihypertensive
medications, including an ACE inhibitor for hypertension. During physical examination, the
patient was hypertensive, tachycardic, tachypnoic, and edematous. During his stay in the ED he was
treated with a combination of corticosteroids, antihistamines and epinephrine, but the patient’s edema
and dyspnea worsened and his oxygen saturation started to deteriorate with a progression of skin
edema. Intubation was not possible due to the large edema of the tongue, so a tracheotomy was done.
An ampule of icatibant was administered and rapid regression of the edema, along with the stabilization
of the patient’s vital signs, followed after five minutes. The patient was discharged home after five
days with a recommendation of discontinuing the ACE inhibitor.
While non-hereditary

Ključne riječi

Angioedema; Bradykinin; Icatibant-B2 Bradykinin Receptor Antagonist

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Podaci na drugim jezicima: hrvatski

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