Prophylactic percutaneous dilatational cricothyrotomy, prior to surgical tracheostomy: Case report

  • Santiago Medina-Ramírez a. Hospital Universitario San Vicente Fundación, Medellín, Colombia. b. Anesthesiology Department, Universidad de Antioquia, Medellín, Colombia
  • Juan Camilo Posada-Upegui Universidad de Antioquia, Medellín, Colombia
  • Lina María Hoyos-Fajardo Hospital Universitario San Vicente Fundación, Medellín, Colombia
  • Diomer Avendaño-Quintero Hospital Universitario San Vicente Fundación, Medellín, Colombia
Keywords: Tracheostomy, Airway management, Airway obstruction, Anesthesia general, Case report

Abstract

Introduction: Percutaneous dilational cricothyrotomy is considered a quick technique to access the airway during urgent situations, especially "cannot intubate/cannot ventilate" scenarios; nevertheless it can also constitute a technique to temporarily and preventative secure the airway in cases of glotic or supraglotic obstruction, in patients in whom interventions of the obstructive lesion or definitive procedures for airway control will be done.

Clinical case: This is a report of a 90 year old patient with symptoms of dyspnea and dysphagia, with a multilobar, friable lesion, with areas of necrosis, suggestive of carcinoma, with involvement of left vallecula, epiglottis and glotis, with 90% occupation of the latter. It is decided to make an urgent tracheostomy. At the time of surgery, in the face of the imminent risk of obstruction, loss of the airway patency and death during the surgical intervention, it was decided to make a percutaneous cricothyrotomy previous to the tracheostomy. There were no complications associated with the airway neither during the procedure nor in the perioperative period.

Conclusion: Percutaneous dilational cricothyrotomy is a quick procedure and can become a valuable tool in securing the airway in cases of critical supraglottic obstruction in patients who will be taken to surgery and carry a risk of loss of permeability of the airway; in this article we make a report of a successful case of it utilization and we review the available evidence on the preventive use of cricothyrotomy and the outcomes in this context.

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How to Cite
1.
Medina-Ramírez S, Posada-Upegui JC, Hoyos-Fajardo LM, Avendaño-Quintero D. Prophylactic percutaneous dilatational cricothyrotomy, prior to surgical tracheostomy: Case report. Colomb. J. Anesthesiol. [Internet]. 2017Apr.1 [cited 2021Jan.26];45(Supplement):16 -20. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/437

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Published
2017-04-01
How to Cite
1.
Medina-Ramírez S, Posada-Upegui JC, Hoyos-Fajardo LM, Avendaño-Quintero D. Prophylactic percutaneous dilatational cricothyrotomy, prior to surgical tracheostomy: Case report. Colomb. J. Anesthesiol. [Internet]. 2017Apr.1 [cited 2021Jan.26];45(Supplement):16 -20. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/437
Section
Case Report / Case Series

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