Anaes Cases · Extubation & recovery
The staged extubation of the difficult airway
The long case — the difficult-airway extubation. The risk assessment (the difficult intubation, the oedema, the prone), the cuff-leak test, the staged extubation over the airway-exchange-catheter, the team ready, the reintubation plan, and the timing.
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Prompt
A patient with the difficult airway and the airway oedema after the prolonged prone surgery. Discuss the extubation plan.
Presentation
A 58-year-old man, the intubation was the difficult (the Cormack-Lehane grade 3, the two attempts, the videolaryngoscopy), is in the ICU after the 8-hour prone spinal surgery, intubated and ventilated. He has the facial and the airway oedema. Discuss the extubation plan.
References3ShowHide
- [1]Cooper RM, et al. Difficult Airway Society guidelines for the management of tracheal extubation. Anaesthesia, 2013.PMID 23298360
- [2]Higgs A, et al. Pre-oxygenation before extubation. Anaesthesia, 2015.PMID 26152265
- [26152266]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.