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[Anesthetic management using veno-veno bypass for emergent tracheostomy in a patient with acute epiglottitis].

Abstract
We report anesthetic management using veno-veno bypass (V-V bypass) for emergent tracheostomy in a patient with acute epiglottitis. A 72-year-old woman complained of dyspnea due to acute epiglottitis, and emergent tracheostomy was planned for her. Since physical and optical fiberscopic examinations indicated a high risk of airway collapse during anesthetic induction, we planned to do tracheostomy under V-V bypass in order to maintain oxygenation. V-V bypass was established using the right femoral and jugular veins in an awake condition. After starting V-V bypass, tracheostomy was performed under intravenous propofol anesthesia. During surgery, bispectral index was maintained below 60. Surgery was carried out with ease and uneventfully. The patient had no complications due to V-V bypass postoperatively.
AuthorsAtsushi Sawada, Tomoyuki Kawamata, Akiyoshi Namiki
JournalMasui. The Japanese journal of anesthesiology (Masui) Vol. 58 Issue 8 Pg. 1004-6 (Aug 2009) ISSN: 0021-4892 [Print] Japan
PMID19702219 (Publication Type: Case Reports, English Abstract, Journal Article)
Topics
  • Acute Disease
  • Aged
  • Anesthesia, Intravenous
  • Emergencies
  • Epiglottitis (surgery)
  • Extracorporeal Circulation (methods)
  • Female
  • Femoral Vein
  • Humans
  • Jugular Veins
  • Tracheostomy

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