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KMID : 0356920190720040381
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Korean Journal of Anesthesiology
2019 Volume.72 No. 4 p.381 ~ p.384
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Use of a trans-tracheal rapid insufflation of oxygen device in a “cannot intubate, cannot oxygenate” scenario in a parturient -a case report
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Lee John
Ng Von Vee
Teo Constance
Wong Patrick
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Abstract
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Background: The trans-tracheal rapid insufflation of oxygen (TRIO) device is less commonly used and is an alternative to trans-tracheal jet ventilation for maintaining oxygenation in a “cannot intubate, cannot oxygenate” (CICO) scenario.
Case: We report the successful use of this device to maintain oxygenation after jet ventilator failure in a parturient who presented with the CICO scenario during the procedure for excision of laryngeal papilloma.
Conclusions: A stepwise approach to the airway plan and preparation for an event of failure is essential for good materno-fetal outcomes. The TRIO device may result in inadequate ventilation that can lead to hypercarbia and respiratory acidosis. Hence, it should only be used as a temporizing measure before a definitive airway can be secured.
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KEYWORD
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Airway management, Airway obstruction, High-frequency jet ventilation, Insufflation, Obstetrical anesthesia, Trans-tracheal rapid insufflation of oxygen (TRIO)
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