Case Report of Multinodular Goiter and Airway Compression in a Preeclamptic Patient

Berg, Erik; Gomes, Heather J.; Conturie, Charlotte L.; Wein, Richard O.

doi:10.7243/2049-9752-1-10

Cited by 6 publications

(8 citation statements)

References 7 publications

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“…We have included 136 reports, both full publications and abstracts, covering 158 cases (see also Supporting Information, Appendices S1–S6) . Case reports largely fall into two groups: those describing equipment, or a technique, for provision of general anaesthesia; or those identifying a woman who had predicted airway difficulty, who was managed with regional analgesia or anaesthesia with the aim of avoiding of general anaesthesia.…”

Section: Resultsmentioning

confidence: 99%

“…Specific pathology‐related airway or respiratory investigations included two‐dimensional airway reconstruction from CT images and intrathoracic anatomy . In 15 women, awake laryngoscopy/nasendoscopy was carried out to assess laryngoscopy view before making a decision on anaesthetic technique , although most of these were before non‐obstetric surgery.…”

Section: Resultsmentioning

confidence: 99%

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Anticipated difficult airway during obstetric general anaesthesia: narrative literature review and management recommendations.

2020

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We reviewed the literature on management of general and regional anaesthesia in pregnant women with anticipated airway difficulty. We identified 138 publications comprising 158 cases; these either described equipment or techniques for the provision of general anaesthesia, or the management of women with regional analgesia or anaesthesia, with the aim of avoiding general anaesthesia. Most of the former group described women requiring caesarean section alone, or in combination with other surgery, which was sometimes airwayrelated. Management techniques were largely similar to those in non-obstetric patients requiring surgery who have airway difficulties, although suggested differences related to physiological changes of pregnancy and avoidance of nasal intubation. In the reports discussing regional anaesthesia, consideration was often given to the possible requirement for urgent out-of-hours anaesthetic intervention, and the predicted difficulty of management of general anaesthesia should it be required. In a number of reported cases, multidisciplinary planning led to the conclusion that elective caesarean section should be performed in order to avoid emergency airway management. Based on this literature review, we advise antenatal planning that includes: assessment of the patient's clinical characteristics; consideration of the equipment and personnel available to provide safe airway management out-of-hours; and elective caesarean section should these be lacking. If general anaesthesia is required, a risk assessment must be made as to the probability of safe airway management after the induction of anaesthesia, and awake tracheal intubation should be used if this cannot be assured. Decision aids are provided to illustrate these points. Online appendices include a comprehensive compendium of case reports on the management of a number of rare syndromes and airway conditions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Anticipated difficult airway during obstetric general anaesthesia: narrative literature review and management recommendations.

2020

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“…30 CPB/ECMO is logistically difficult to set up and the timing of femoral cannulation varies. Some authors have established vascular access or even established bypass before securing the airway, 31-34 whereas others have done so only after AFOI. 35,36 It must be noted that it takes several minutes to cannulate the femoral vessels and achieve full bypass, and this delay may result in brain hypoxia.…”

Section: Awake Techniques For Surgery and Airway Managementmentioning

confidence: 99%

Anaesthesia for goitre surgery: A review

Wong

Liew

Kothandan

2015

Proceedings of Singapore Healthcare

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Goitres are relatively common and, in extreme cases, present unique challenges (particularly in airway management) for the anaesthetist. There are no specific guidelines from the Difficult Airway Society (United Kingdom) or the American Society of Anesthesiologists for the management of the obstructed airway. We therefore present the principles governing the provision of safe anaesthesia for goitre surgery including formulating a plan ABC for patients with a stable airway and for those presenting with acute airway obstruction.

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“…Due to the logistical difficulties in setting up cardiopulmonary bypass, some authors have only established it after securing the airway, (81,82) rather than before. (106)(107)(108)(109) (2,4) In addition, recent advances (such as the use of muscle relaxants and sugammadex, videolaryngoscopy, jet ventilation, and cardiopulmonary bypass) offer more options for anaesthesiologists. The decision-making process in AAO management should be based on individual circumstances, including patient status, location and extent of the obstruction, pathology, degree of urgency, and availability of expertise and facilities.…”

Section: Formulating Plans a B And Cmentioning

confidence: 99%

Anaesthetic management of acute airway obstruction

Wong¹,

Wong²,

Mok³

2016

smedj

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The acutely obstructed airway is a medical emergency that can potentially result in serious morbidity and mortality. Apart from the latest advancements in anaesthetic techniques, equipment and drugs, publications relevant to our topic, including the United Kingdom's 4th National Audit Project on major airway complications in 2011 and the updated American Society of Anesthesiologists' difficult airway algorithm of 2013, have recently been published. The former contained many reports of adverse events associated with the management of acute airway obstruction. By analysing the data and concepts from these two publications, this review article provides an update on management techniques for the acutely obstructed airway. We discuss the principles and factors relevant to the decision-making process in formulating a logical management plan.

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Case Report of Multinodular Goiter and Airway Compression in a Preeclamptic Patient

Abstract: Background: We describe the management of a pregnant female with preeclampsia, who presented at 33 weeks gestation in respiratory distress secondary to compression from a multinodular goiter.

Cited by 6 publications

References 7 publications

Anticipated difficult airway during obstetric general anaesthesia: narrative literature review and management recommendations.

Anticipated difficult airway during obstetric general anaesthesia: narrative literature review and management recommendations.

Anaesthesia for goitre surgery: A review

Anaesthetic management of acute airway obstruction

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