The difficult airway: Cardiopulmonary bypass—The ultimate solution

✍ Scribed by Michael J. Belmont; Mark K. Wax; Fructosa N. DeSouza

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 79 KB
• Volume: 20
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/(sici)1097-0347(199805)20:3<266::aid-hed12>3.0.co;2-i

✦ Synopsis

Background. Large, compressive thyroid masses are usually removed as an elective procedure. Rarely is a patient's condition allowed to progress to severe respiratory distress before surgical intervention is recommended. When allowed to progress, management of the airway can be problematic.

Methods. A case report of a patient with a neglected thyroid lymphoma is presented.

Results. The natural progression of the disease, leading to impending airway collapse, necessitated emergency management of the airway. Due to supraglottic edema and a large neck mass, traditional methods of securing the airway were not feasible. Initiation of femoral-femoral cardiopulmonary bypass, under local anesthesia, ensured adequate oxygenation and allowed a controlled tracheotomy to be performed.

Conclusions. The result obtained suggests that this approach provides a safe solution for airway control when intubation or a surgically created airway is either unsuccessful or too hazardous.