Difficult Airway Due to an Undiagnosed Subglottic Tumor: A Case Report
The "cannot ventilate, cannot intubate" scenario during anesthesia induction can be lethal. We present a patient with an undiagnosed subglottic tumor who developed the "cannot ventilate, cannot intubate" situation after induction of general anesthesia, due to the presence of an u...
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| Veröffentlicht in: | Medicine (Baltimore) 2016-04, Vol.95 (15), p.e3383-e3383 |
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| container_title | Medicine (Baltimore) |
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| creator | Uzawa, Kohji Tokumine, Joho Lefor, Alan Kawarai Takagi, Toshiyuki Watanabe, Kunitaro Yorozu, Tomoko |
| description | The "cannot ventilate, cannot intubate" scenario during anesthesia induction can be lethal. We present a patient with an undiagnosed subglottic tumor who developed the "cannot ventilate, cannot intubate" situation after induction of general anesthesia, due to the presence of an undiagnosed subglottic tumor. A 93-year-old woman was brought to the operating room for repair of a femoral neck fracture. Both ventilation and intubation could not be accomplished, and the patient was awakened without complications after trials of maintaining the airway. In order to reverse muscle relaxation, sugammadex was useful to allow resumption of spontaneous breathing. A difficult airway can be caused by an undiagnosed subglottic tumor. Subglottic tumors can be misdiagnosed as asthma, because the clinical presentation can be very similar. If cricothyrotomy had been performed based on airway management algorithms, the airway may not have been controlled with a possibly fatal outcome. Ultrasound examination of the trachea may be useful to diagnose obstructive lesions in the airway. |
| doi_str_mv | 10.1097/MD.0000000000003383 |
| format | Article |
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We present a patient with an undiagnosed subglottic tumor who developed the "cannot ventilate, cannot intubate" situation after induction of general anesthesia, due to the presence of an undiagnosed subglottic tumor. A 93-year-old woman was brought to the operating room for repair of a femoral neck fracture. Both ventilation and intubation could not be accomplished, and the patient was awakened without complications after trials of maintaining the airway. In order to reverse muscle relaxation, sugammadex was useful to allow resumption of spontaneous breathing. A difficult airway can be caused by an undiagnosed subglottic tumor. Subglottic tumors can be misdiagnosed as asthma, because the clinical presentation can be very similar. If cricothyrotomy had been performed based on airway management algorithms, the airway may not have been controlled with a possibly fatal outcome. Ultrasound examination of the trachea may be useful to diagnose obstructive lesions in the airway.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000003383</identifier><identifier>PMID: 27082606</identifier><language>eng</language><publisher>United States: The Authors. Published by Wolters Kluwer Health, Inc. Health, Inc. All rights reserved</publisher><subject>Aged, 80 and over ; Airway Management ; Airway Obstruction - etiology ; Anesthesia, General ; Clinical Case Report ; Female ; Femoral Neck Fractures - surgery ; Humans ; Intubation, Intratracheal ; Laryngeal Neoplasms - complications</subject><ispartof>Medicine (Baltimore), 2016-04, Vol.95 (15), p.e3383-e3383</ispartof><rights>The Authors. Published by Wolters Kluwer Health, Inc. Health, Inc. All rights reserved.</rights><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2859-37a8b5554ec8d0f28d7575da882a00782a54076d9f43c3d074cb7c978f6670ef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839850/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839850/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27082606$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uzawa, Kohji</creatorcontrib><creatorcontrib>Tokumine, Joho</creatorcontrib><creatorcontrib>Lefor, Alan Kawarai</creatorcontrib><creatorcontrib>Takagi, Toshiyuki</creatorcontrib><creatorcontrib>Watanabe, Kunitaro</creatorcontrib><creatorcontrib>Yorozu, Tomoko</creatorcontrib><title>Difficult Airway Due to an Undiagnosed Subglottic Tumor: A Case Report</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>The "cannot ventilate, cannot intubate" scenario during anesthesia induction can be lethal. We present a patient with an undiagnosed subglottic tumor who developed the "cannot ventilate, cannot intubate" situation after induction of general anesthesia, due to the presence of an undiagnosed subglottic tumor. A 93-year-old woman was brought to the operating room for repair of a femoral neck fracture. Both ventilation and intubation could not be accomplished, and the patient was awakened without complications after trials of maintaining the airway. In order to reverse muscle relaxation, sugammadex was useful to allow resumption of spontaneous breathing. A difficult airway can be caused by an undiagnosed subglottic tumor. Subglottic tumors can be misdiagnosed as asthma, because the clinical presentation can be very similar. If cricothyrotomy had been performed based on airway management algorithms, the airway may not have been controlled with a possibly fatal outcome. Ultrasound examination of the trachea may be useful to diagnose obstructive lesions in the airway.</description><subject>Aged, 80 and over</subject><subject>Airway Management</subject><subject>Airway Obstruction - etiology</subject><subject>Anesthesia, General</subject><subject>Clinical Case Report</subject><subject>Female</subject><subject>Femoral Neck Fractures - surgery</subject><subject>Humans</subject><subject>Intubation, Intratracheal</subject><subject>Laryngeal Neoplasms - complications</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUU1vEzEQtRCIpoVfgIR85LLt-NvmgBQlFJBaVYL2bDleb2LYrIPtJeq_70LaqnQOM9LMe29G8xB6R-CUgFFnl8tTeBKMafYCzYhgshFG8pdoBkBFo4ziR-i4lJ8AhCnKX6MjqkBTCXKGzpex66If-4rnMe_dLV6OAdeE3YBvhja69ZBKaPGPcbXuU63R4-txm_JHPMcLVwL-HnYp1zfoVef6Et7e1xN0c_75evG1ubj68m0xv2g81cI0TDm9EkLw4HULHdWtEkq0TmvqANSUBQclW9Nx5lkLivuV8kbpTkoFoWMn6NNBdzeutqH1YajZ9XaX49blW5tctP9Phrix6_THcs2MFjAJfLgXyOn3GEq121h86Hs3hDQWS5QmglOh6QRlB6jPqZQcusc1BOxfB-zl0j53YGK9f3rhI-fh5ROAHwD71NeQy69-3IdsN8H1dfNPTyhDGwpEAicUmqkjDbsDziKPyg</recordid><startdate>20160401</startdate><enddate>20160401</enddate><creator>Uzawa, Kohji</creator><creator>Tokumine, Joho</creator><creator>Lefor, Alan Kawarai</creator><creator>Takagi, Toshiyuki</creator><creator>Watanabe, Kunitaro</creator><creator>Yorozu, Tomoko</creator><general>The Authors. Published by Wolters Kluwer Health, Inc. Health, Inc. All rights reserved</general><general>Wolters Kluwer Health</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160401</creationdate><title>Difficult Airway Due to an Undiagnosed Subglottic Tumor: A Case Report</title><author>Uzawa, Kohji ; Tokumine, Joho ; Lefor, Alan Kawarai ; Takagi, Toshiyuki ; Watanabe, Kunitaro ; Yorozu, Tomoko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2859-37a8b5554ec8d0f28d7575da882a00782a54076d9f43c3d074cb7c978f6670ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged, 80 and over</topic><topic>Airway Management</topic><topic>Airway Obstruction - etiology</topic><topic>Anesthesia, General</topic><topic>Clinical Case Report</topic><topic>Female</topic><topic>Femoral Neck Fractures - surgery</topic><topic>Humans</topic><topic>Intubation, Intratracheal</topic><topic>Laryngeal Neoplasms - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uzawa, Kohji</creatorcontrib><creatorcontrib>Tokumine, Joho</creatorcontrib><creatorcontrib>Lefor, Alan Kawarai</creatorcontrib><creatorcontrib>Takagi, Toshiyuki</creatorcontrib><creatorcontrib>Watanabe, Kunitaro</creatorcontrib><creatorcontrib>Yorozu, Tomoko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uzawa, Kohji</au><au>Tokumine, Joho</au><au>Lefor, Alan Kawarai</au><au>Takagi, Toshiyuki</au><au>Watanabe, Kunitaro</au><au>Yorozu, Tomoko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Difficult Airway Due to an Undiagnosed Subglottic Tumor: A Case Report</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2016-04-01</date><risdate>2016</risdate><volume>95</volume><issue>15</issue><spage>e3383</spage><epage>e3383</epage><pages>e3383-e3383</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>The "cannot ventilate, cannot intubate" scenario during anesthesia induction can be lethal. We present a patient with an undiagnosed subglottic tumor who developed the "cannot ventilate, cannot intubate" situation after induction of general anesthesia, due to the presence of an undiagnosed subglottic tumor. A 93-year-old woman was brought to the operating room for repair of a femoral neck fracture. Both ventilation and intubation could not be accomplished, and the patient was awakened without complications after trials of maintaining the airway. In order to reverse muscle relaxation, sugammadex was useful to allow resumption of spontaneous breathing. A difficult airway can be caused by an undiagnosed subglottic tumor. Subglottic tumors can be misdiagnosed as asthma, because the clinical presentation can be very similar. If cricothyrotomy had been performed based on airway management algorithms, the airway may not have been controlled with a possibly fatal outcome. Ultrasound examination of the trachea may be useful to diagnose obstructive lesions in the airway.</abstract><cop>United States</cop><pub>The Authors. Published by Wolters Kluwer Health, Inc. Health, Inc. All rights reserved</pub><pmid>27082606</pmid><doi>10.1097/MD.0000000000003383</doi><oa>free_for_read</oa></addata></record> |
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| source | Wolters Kluwer Open Health; MEDLINE; DOAJ Directory of Open Access Journals; IngentaConnect Free/Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged, 80 and over Airway Management Airway Obstruction - etiology Anesthesia, General Clinical Case Report Female Femoral Neck Fractures - surgery Humans Intubation, Intratracheal Laryngeal Neoplasms - complications |
| title | Difficult Airway Due to an Undiagnosed Subglottic Tumor: A Case Report |
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