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Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske, Vol. 72 No. Suplement 1, 2018.

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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 id orcid.org/0000-0003-2701-9919 ; Clinical Centre of Vojvodina, Department of Anesthesiology, ENT Department, Novi Sad, Serbia
VLADIMIR DOLINAJ orcid id orcid.org/0000-0002-2092-5479 ; Clinical Centre of Vojvodina, Department of Anesthesiology, ENT Department, Novi Sad, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
DRAGANA RADOVANOVIĆ orcid id orcid.org/0000-0002-5071-7929 ; Institute for Oncology of Vojvodina, Department of Operative Oncology, Division of Anesthesiology, Novi Sad, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
VLADIMIR KLJAJIĆ ; Clinical Centre of Vojvodina, ENT Department, Division of Laryngology, Novi Sad, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
NATAŠA MARKOVIĆ orcid id orcid.org/0000-0003-0494-0377 ; Subotica General Hospital, ENT Department, Division of Anesthesiology, Subotica, Serbia
DUŠANKA JANJEVIĆ ; Clinical Centre of Vojvodina, Department of Anesthesiology, ENT Department, Novi Sad, Serbia

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Abstract

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.

Keywords

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

Hrčak ID:

209077

URI

https://hrcak.srce.hr/209077

Publication date:

18.11.2018.

Article data in other languages: croatian

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