Anaes SAQs · Airway management
Extubation of the difficult airway — a planned procedure
Final-viva question on the planned, stepwise extubation of the difficult airway: risk stratification, preparation, awake versus deep, the airway exchange catheter as stent and rescue, and the recognition and management of laryngospasm and negative-pressure pulmonary oedema.
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Prompt
A patient with a documented difficult airway has just completed uncomplicated surgery. Describe your approach to safely extubating this patient, including the precautions you would take and the role of the airway exchange catheter.
Question
A patient with a documented difficult airway has just completed uncomplicated surgery. Describe your approach to safely extubating this patient, including the precautions you would take and the role of the airway exchange catheter[7][1].
References6ShowHide
- [1]Garioud A, et al. Pressure-Limited Oxygen Insufflation via the Airway Exchange Catheter: An In Vitro Study. A&A Practice, 2026.PMID 41879505
- [2]Saurabh K, et al. Effect of Semi-sitting Position on Airway Clearance Obtained by Jaw Thrust During Oral Fiberoptic-Guided Intubation. Cureus, 2026.PMID 42338868
- [3]Shrestha BR, et al. Negative Pressure Pulmonary Edema Following Septorhinoplasty. Kathmandu Univ Med J (KUMJ), 2025.PMID 42318738
- [5]He ZY, et al. Comparison of propofol-remifentanil target-controlled infusion with lidocaine versus neuromuscular blockade for laryngoscopy. Minerva Anestesiol, 2026.PMID 42267885
- [7]Popat M, et al. Difficult Airway Society Guidelines for the management of tracheal extubation. Anaesthesia, 2012.PMID 22321104
- [8]Zhou T, et al. Cuff-leak test for predicting postextubation airway complications: a systematic review. J Evid Based Med, 2011.PMID 23672755