Two patients with CICV (cannot intubate cannot ventilate) rescued by cricothyrotomy
Morishima, K.; Kurita, S.; Yamama, Y.; Nakatani, K.
Masui. Japanese Journal of Anesthesiology 62(12): 1406-1409
2013
ISSN/ISBN: 0021-4892 PMID: 24498769 Document Number: 664197
The first case was a 69-year-old woman with rheumatoid arthritis undergoing posterior occipito-cervical fusion. Although the operation was successfully performed, airway obstruction developed immediately after extubation. Her upper airway obstruction probably came from pharyngolaryngeal edema. The second case was a 59-year-old man with diabetes mellitus undergoing anterior cervical fusion. The day of surgery, he complained of dyspnea and his neck was swollen with hematoma. We used cricothyrotomy tubes (Mini-Trach II) in these two patients with postoperative upper airway obstruction and performed assist-ventilation via the tube. After starting ventilation through Mini-Trach II, we succeeded in intubation. We belive that cricothyrotomy in well-trained hands can be used safely for the management of the patient with a difficult airway.