Recenzija, prikaz
https://doi.org/10.20471/acc.2023.62.s1.23
Neck Hematoma after Central Venous Catheterization and Awake Intubation as Rescue Airway Management Technique: A Case Report
Matea Mrčelić
; Department of Anesthesiology, Resuscitation, Intensive Medicine and Pain Therapy, Zagreb University Hospital Center, Zagreb, Croatia
Renata Curić Radivojević
orcid.org/0000-0002-3666-0516
; Department of Anesthesiology, Resuscitation, Intensive Medicine and Pain Therapy, Zagreb University Hospital Center, Zagreb, Croatia
Marina Kljaković-Gašpić Batinjan
; Department of Anesthesiology, Resuscitation, Intensive Medicine and Pain Therapy, Zagreb University Hospital Center, Zagreb, Croatia
Sažetak
Central venous catheterization (CVC) of the internal jugular vein is an invasive
procedure commonly performed in anesthesiology practice. Usually it is an uneventful procedure but
complications such as bleeding, infection, and potential damage to the surrounding structures can occur.
One of the complications is neck hematoma, which can distort airway anatomy and cause upper airway
obstruction. We present a patient who underwent endovascular mitral valve repairment procedure under
general anesthesia. Accidental puncture of carotid artery occurred while attempting to place the central
line. Later, during awakening in the coronary intensive care unit, the patient developed neck hematoma.
The diagnosis was confirmed with multi-slice computed tomography (MSCT) and MSCT angiography
showed active arterial blood extravasation. Despite it, the patient was extubated. Awake tracheal intubation
(ATI) with video laryngoscopy was the technique of choice for reintubation because of the neck
swelling and compression onto laryngeal structures. In this case, rushed extubation put the patient at risk.
Video laryngoscopy ATI with appropriate preparation and titrated sedation can enable quick and safe
rescue airway management in patients with rapidly developing neck hematoma, along with definitive
evacuation and treatment.
Ključne riječi
Neck hematoma; Advanced airway management; Central venous catheterization
Hrčak ID:
307566
URI
Datum izdavanja:
1.4.2023.
Posjeta: 421 *