The role of Anaesthesiologists at Different Levels of Difficult Airway Management Care - A Case Report

Detalhes bibliográficos
Autor(a) principal: Pacheco, Marta
Data de Publicação: 2022
Outros Autores: Castro, Rita, Aguiar, José, Órfão, Jorge
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.25751/rspa.21883
Resumo: Mucopolysaccharidoses are a group of lysosomal storage diseases. The deficiency of specific lysosomal enzymes leads to accumulation of glycosaminoglycans (GAGs) in the tissues and organs. Patients had Difficult Airway (DA) criteria: long epiglottis, anterior larynx, small trachea, short neck, temporo-mandibular joint rigidity, cervical instability and complications with difficult ventilation and oxygenation. We describe a case that illustrates the role of the anaesthesiologist in the approach and maintenance of a DA during the disease progression. DA criteria made the maintenance of spontaneous ventilation a primary goal and fiberoptic should be the first approach. A precarious definitive airway and previous respiratory arrest linked to infraglotic obstruction, made manipulation of the tracheostomy cannula stressing, dangerous and not definitive. Trained anaesthesiologists in DA, fiberoptic and FROVA allowed safe diagnosis and exchange the cannula safely.
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spelling The role of Anaesthesiologists at Different Levels of Difficult Airway Management Care - A Case ReportO Papel do Anestesiologista em Diferentes Níveis da Abordagem da Via Aérea Difícil – Um Caso ClínicoCaso ClínicoMucopolysaccharidoses are a group of lysosomal storage diseases. The deficiency of specific lysosomal enzymes leads to accumulation of glycosaminoglycans (GAGs) in the tissues and organs. Patients had Difficult Airway (DA) criteria: long epiglottis, anterior larynx, small trachea, short neck, temporo-mandibular joint rigidity, cervical instability and complications with difficult ventilation and oxygenation. We describe a case that illustrates the role of the anaesthesiologist in the approach and maintenance of a DA during the disease progression. DA criteria made the maintenance of spontaneous ventilation a primary goal and fiberoptic should be the first approach. A precarious definitive airway and previous respiratory arrest linked to infraglotic obstruction, made manipulation of the tracheostomy cannula stressing, dangerous and not definitive. Trained anaesthesiologists in DA, fiberoptic and FROVA allowed safe diagnosis and exchange the cannula safely.As Mucopolissacaridoses pertencem ao grupo das doenças lisossomais de sobrecarga, nas quais a deficiência de enzimas lisossomais leva à acumulação de glicosaminoglicanos nos tecidos e órgãos. Os doentes apresentam habitualmente critérios de via aérea difícil: epiglote longa, laringe anterior, traqueia e pescoço curtos, rigidez da articulação temporo-mandibular, instabilidade cervical e ventilação e oxigenação difíceis. Descrevemos um caso que ilustra o papel do Anestesiologista na abordagem e manutenção da via aérea difícil durante a progressão da doença. Neste caso, os critérios de via aérea difícil tornaram a manutenção da ventilação espontânea um objetivo primordial, sendo a abordagem por fibroscopia a técnica de eleição. A via aérea definitiva precária e a paragem cardiorrespiratória prévia associada à obstrução infraglótica tornaram a manipulação da cânula de traqueostomia um ponto crítico e perigoso. Anestesiologistas treinados em via aérea difícil e fibroscopia foram o elemento-chave para o diagnóstico e a manipulação segura da cânula de traqueostomia.Sociedade Portuguesa de Anestesiologia2022-01-07T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25751/rspa.21883eng0871-6099Pacheco, MartaCastro, RitaAguiar, JoséÓrfão, Jorgeinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-23T15:34:52Zoai:ojs.revistas.rcaap.pt:article/21883Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:04:19.221769Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv The role of Anaesthesiologists at Different Levels of Difficult Airway Management Care - A Case Report
O Papel do Anestesiologista em Diferentes Níveis da Abordagem da Via Aérea Difícil – Um Caso Clínico
title The role of Anaesthesiologists at Different Levels of Difficult Airway Management Care - A Case Report
spellingShingle The role of Anaesthesiologists at Different Levels of Difficult Airway Management Care - A Case Report
Pacheco, Marta
Caso Clínico
title_short The role of Anaesthesiologists at Different Levels of Difficult Airway Management Care - A Case Report
title_full The role of Anaesthesiologists at Different Levels of Difficult Airway Management Care - A Case Report
title_fullStr The role of Anaesthesiologists at Different Levels of Difficult Airway Management Care - A Case Report
title_full_unstemmed The role of Anaesthesiologists at Different Levels of Difficult Airway Management Care - A Case Report
title_sort The role of Anaesthesiologists at Different Levels of Difficult Airway Management Care - A Case Report
author Pacheco, Marta
author_facet Pacheco, Marta
Castro, Rita
Aguiar, José
Órfão, Jorge
author_role author
author2 Castro, Rita
Aguiar, José
Órfão, Jorge
author2_role author
author
author
dc.contributor.author.fl_str_mv Pacheco, Marta
Castro, Rita
Aguiar, José
Órfão, Jorge
dc.subject.por.fl_str_mv Caso Clínico
topic Caso Clínico
description Mucopolysaccharidoses are a group of lysosomal storage diseases. The deficiency of specific lysosomal enzymes leads to accumulation of glycosaminoglycans (GAGs) in the tissues and organs. Patients had Difficult Airway (DA) criteria: long epiglottis, anterior larynx, small trachea, short neck, temporo-mandibular joint rigidity, cervical instability and complications with difficult ventilation and oxygenation. We describe a case that illustrates the role of the anaesthesiologist in the approach and maintenance of a DA during the disease progression. DA criteria made the maintenance of spontaneous ventilation a primary goal and fiberoptic should be the first approach. A precarious definitive airway and previous respiratory arrest linked to infraglotic obstruction, made manipulation of the tracheostomy cannula stressing, dangerous and not definitive. Trained anaesthesiologists in DA, fiberoptic and FROVA allowed safe diagnosis and exchange the cannula safely.
publishDate 2022
dc.date.none.fl_str_mv 2022-01-07T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.25751/rspa.21883
url https://doi.org/10.25751/rspa.21883
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 0871-6099
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Anestesiologia
publisher.none.fl_str_mv Sociedade Portuguesa de Anestesiologia
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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