Addressing desaturation in a tracheal stenosis patient using the transnasal humidified rapid-insufflation ventilatory exchange technique during tracheostomy: A case report

Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is used in tracheostomy but not in cases of airway obstruction. This case report explores the use of THRIVE for managing airway obstruction during tracheostomy in patients with subglottic and tracheal stenosis, thereby addressing...

Full description

Saved in:
Bibliographic Details
Published in:Medicine (Baltimore) 2023-08, Vol.102 (31), p.e34567-e34567
Main Authors: Lee, Sou Hyun, Cho, Eunyoung, Park, Ji Hoon, Lee, Jae Yun, Hong, Ji Hee, Han, Hyeji
Format: Article
Language:English
Subjects:
Administration, Intranasal
Airway Obstruction - complications
Apnea - therapy
Clinical Case Report
Female
Humans
Insufflation - adverse effects
Middle Aged
Tracheal Stenosis - complications
Tracheal Stenosis - surgery
Tracheostomy - adverse effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is used in tracheostomy but not in cases of airway obstruction. This case report explores the use of THRIVE for managing airway obstruction during tracheostomy in patients with subglottic and tracheal stenosis, thereby addressing the current knowledge gap and exploring its potential for airway management. A 63-year-old female with subglottic and tracheal stenoses underwent tracheostomy. Multiple attempts to establish a patent airway were unsuccessful, and oxygen saturation dropped to 56%. Endotracheal tube was directed toward the tracheal wall, causing airway obstruction. THRIVE was administered to the patient. Subsequently, the tube position was adjusted to enhance ventilation. The patient's oxygen saturation increased to 99%. The postoperative complications, including subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumopericardium, resolved. The patient was discharged on postoperative day 9. THRIVE could be considered a temporary measure to enhance oxygenation before initiating a definitive treatment strategy.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000034567