Airway Procedures

2019 ◽  
Author(s):  
Ju-Mei Ng
Keyword(s):  
Airway Obstruction ◽  
Respiratory Function ◽  
Anesthetic Management ◽  
Rigid Bronchoscopy ◽  
Intravenous Anesthesia ◽  
Interventional Pulmonology ◽  
Central Airway Obstruction ◽  
Airway Stenting ◽  
Key Words Anesthesia ◽  
Central Airway

There has been a marked increase in the number and complexity of airway procedures performed both in the operating room and procedural areas. The anesthesiologist is challenged with establishing a patent shared airway and maintaining adequate gas exchange in patients with compromised airways and/or respiratory function. This review presents a general approach to the patient presenting for an airway procedure and highlights the commonly occurring complications. Airway fire, bleeding, and airway disruption or obstruction may occur. Some of the newer interventional bronchoscopic procedures are introduced, with emphasis on anesthetic implications. A more detailed discussion surrounds the anesthetic management of central airway obstruction and airway stenting. This review contains 8 figures, 5 tables, 30 references.  Key Words: anesthesia for flexible bronchoscopy, anesthesia for rigid bronchoscopy, airway stenting, bronchoscopy, central airway obstruction, interventional pulmonology, total intravenous anesthesia, ventilation

Airway Procedures

2018 ◽  
Author(s):  
Ju-Mei Ng
Keyword(s):  
Airway Obstruction ◽  
Respiratory Function ◽  
Anesthetic Management ◽  
Rigid Bronchoscopy ◽  
Intravenous Anesthesia ◽  
Interventional Pulmonology ◽  
Central Airway Obstruction ◽  
Airway Stenting ◽  
Key Words Anesthesia ◽  
Central Airway

There has been a marked increase in the number and complexity of airway procedures performed both in the operating room and procedural areas. The anesthesiologist is challenged with establishing a patent shared airway and maintaining adequate gas exchange in patients with compromised airways and/or respiratory function. This review presents a general approach to the patient presenting for an airway procedure and highlights the commonly occurring complications. Airway fire, bleeding, and airway disruption or obstruction may occur. Some of the newer interventional bronchoscopic procedures are introduced, with emphasis on anesthetic implications. A more detailed discussion surrounds the anesthetic management of central airway obstruction and airway stenting. This review contains 8 figures, 5 tables, 30 references.  Key Words: anesthesia for flexible bronchoscopy, anesthesia for rigid bronchoscopy, airway stenting, bronchoscopy, central airway obstruction, interventional pulmonology, total intravenous anesthesia, ventilation

scholarly journals Revisiting bronchoscopic intratumoral chemotherapy in malignant central airway obstruction via EUS-B approach and its review of literature

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Ram Niwas ◽  
Gopal Chawla ◽  
Puneet Pareek ◽  
Nishant Kumar Chauhan ◽  
Naveen Dutt
Keyword(s):  
Airway Obstruction ◽  
Rigid Bronchoscopy ◽  
Endobronchial Ultrasound ◽  
Atlantoaxial Instability ◽  
Jet Ventilation ◽  
Central Airway Obstruction ◽  
Intratumoral Chemotherapy ◽  
Airway Stenting ◽  
Central Airway ◽  
Tracheal Tumors

Critical central airway obstruction has always been a dreaded complication to which interventional pulmonologist commonly encounters. There have been various modalities which are used for the management and palliation, which includes mechanical coring, laser, cryoextraction, electrocautery and airway stenting. Rigid bronchoscopy with or without jet ventilation has been corner stone of therapeutics and palliation of central airway obstruction. There are only a few conditions where it is not possible to use rigid bronchoscopy. Here we report a case of metastatic tracheal tumour which presented with critical airway obstruction in a patient who had atlantoaxial instability (AAI) due to rheumatoid arthritis. Here we used endobronchial ultrasound scope (EBUS) via esophageal route, i.e. EUS-B guided approach for sampling of the tracheal tumour, and intratumoral chemotherapy was instilled in multiple sessions, which resulted in shrinking of tumour, thus relieving the critical airway obstruction. This is the first report of using EUS-B approach for intratumoral chemotherapy for tracheal tumors. Bronchoscopic intratumoral chemotherapy therapy (BITC) in tracheal tumors is also one of the options but has not been explored much and there has been a dearth of literature for it.

scholarly journals Pulmonary Infections Following Airway Stenting in Malignant Central Airway Obstruction

CHEST Journal ◽  
2011 ◽  
Vol 140 (4) ◽  
pp. 474A
Author(s):  
Archan Shah ◽  
Pushan Jani ◽  
George Eapen ◽  
Carlos Jimenez ◽  
Mona Sarkiss ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Pulmonary Infections ◽  
Central Airway Obstruction ◽  
Airway Stenting ◽  
Central Airway

scholarly journals RIGID BRONCHOSCOPY AND DEBULKING IN CASE OF CENTRAL AIRWAY OBSTRUCTION BY METASTATIC ESOPHAGEAL TUMOR RESCUED BY ECMO

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A1597
Author(s):  
Samiksha Gupta ◽  
Mukund Tiwari ◽  
Miloni Parmar ◽  
Fernando Figueroa Rodriguez ◽  
Taha Khan
Keyword(s):  
Airway Obstruction ◽  
Rigid Bronchoscopy ◽  
Esophageal Tumor ◽  
Central Airway Obstruction ◽  
Central Airway

One Lung Ventilation in a Patient with Central Airway Obstruction: Fluoroscopic Guided Bronchial Blocker Placement

2021 ◽  
Author(s):  
Ankit A Gupta
Keyword(s):  
Lymph Nodes ◽  
Airway Obstruction ◽  
Traditional Approach ◽  
Anesthetic Management ◽  
Lung Ventilation ◽  
Bronchial Blocker ◽  
One Lung Ventilation ◽  
Central Airway Obstruction ◽  
Thyroid Mass ◽  
Central Airway

Thyroidectomy is the most common endocrine surgical treatment performed worldwide. Medullary thyroid carcinoma which accounts for less than 1.5 percent of these cases is different from other types of thyroid cancers in a way that it is a neuroendocrine malignancy that originates from the parafollicular C cells of the thyroid gland secreting calcitonin and it frequently spreads to lymph nodes and other organs. Anesthetic management in a case of a large thyroid mass with central airway obstruction is a task cut out for an anesthesiologist and the need to provide one-lung ventilation in these patients for thoracoscopic dissection of mediastinal lymph nodes adds to the challenges. In this case report, we describe fluoroscopic guided bronchial blocker placement as a novel technique for delivering one-lung ventilation in such patients, when the traditional approach of bronchial blocker placement with concomitant use of a fiber optic bronchoscope was not practicable due to the small size of the endotracheal tube in the presence of central airway obstruction.

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