Use of CobraPLA^TM for airway management in a neonate with Desbuquois syndrome. Case report and anesthetic implications

Abstract

We present the anesthetic management of an infant with Desbuquois syndrome (a rare form of micromelic dwarfism) with a possible difficult airway. The anesthetic implications of this syndrome are presented. The airway was managed with a new supraglottic device - the CobraPLA. Although intubation through this device was not possible in this instance, CobraPLA provided a satisfactory supraglottic airway. It was easy to insert and provided satisfactory conditions for positive pressure ventilation. The CobraPLA provides another option for airway management.

Insertion characteristics, sealing pressure and fiberoptic positioning of CobraPLA in children

“…The CobraPLA TM has been used in children for the airway management in Desbuquois syndrome (4), in a child with neck instability (6), and during fiberoptic bronchoscopy (5). Fiber‐optic assessment of CobraPLA TM position in our study confirms correct anatomical location as the device was placed centrally in almost 80% of patients and the vocal cords were visualized (scores 2–4) in 90% of patients.…”

Brief review: The Cobra Perilaryngeal Airway (CobraPLA®) and the Streamlined Liner of Pharyngeal Airway (SLIPA™) supraglottic airways

“…26 Moreover, the CobraPLA® has been reported as being successful in the management of a difficult airway: in single cases of the Intubating LMA TM 's failure as a means of securing the airway; 27 for the difficult to intubate/ventilate scenario; 28 and in the airway management of a neonate with Desbuquois syndrome. 29 Successful, lighted, stylet-guided, tracheal intubation through a CobraPLA® has been reported, after repeated failure to intubate through an Intubating LMA TM . These reports suggest that the CobraPLA® may act as an alternative rescue airway in difficult airway scenarios.…”

Tube obstruction of CobraPLA in a patient with fixed flexed neck

“…We [2] and others [3] have had similar success with the CobraPLA in managing difficult airways. Khan et al [3] de-…”