Book review
https://doi.org/10.20471/acc.2023.62.s1.20
Combined Use of Videolaryngoscope and Bonfils Intubation Endoscope as Rescue Option for Difficult Airway Management: A Case Report
Marina Kljaković-Gašpić Batinjan
orcid.org/0000-0002-9406-4333
; Department of Anesthesiology, Resuscitation, Intensive Medicine and Pain Therapy, Zagreb University Hospital Center, Zagreb, Croatia
Igor Vlatković
; Department of Anesthesiology, Resuscitation, Intensive Medicine and Pain Therapy, Zagreb University Hospital Center, Zagreb, Croatia
Karlo Vidović
orcid.org/0000-0002-9622-4978
; 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
Željko Čolak
; Department of Anesthesiology, Resuscitation, Intensive Medicine and Pain Therapy, Zagreb University Hospital Center, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Abstract
Difficult airway management poses a great challenge for clinicians, especially if it is
unanticipated. Numerous guidelines and a wide array of devices constitute the anesthesiologist’s armamentarium
for managing the airway. When the use of individual devices fails, the use of combination
techniques is advised. We present a case of difficult intubation in a 50-year-old male patient scheduled
for aortic valve replacement. He had no prior history of difficult airway management, and no abnormalities
were detected on preoperative airway assessment. Body mass index was 29 kg/m2. After the
separate use of direct laryngoscopy, videolaryngoscopy and a BONFILS intubation endoscope (BIE)
had failed, we resorted to a combination technique, combining videolaryngoscopy and BIE. While the
videolaryngoscope provided the space needed for BIE and visual guidance through copious secretions,
the BIE served as a stylet for endotracheal tube guidance, leading to successful intubation. Since the
technique requires costly equipment, experience in handling it and at least two operators, it is more
appropriate as a rescue measure than an elective procedure. Given the potentially disastrous outcomes of
failed intubation, mastering advanced airway management techniques remains of vital importance, and
the combination technique is one of them.
Keywords
Airway management; Anesthesia; Aortic valve; Body mass index; Intubation, intratracheal; Laryngoscopy; Optical devices
Hrčak ID:
307563
URI
Publication date:
1.4.2023.
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