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Airway management in patients with epiglottitis Masayuki OZAKI 1 1Department Emergency and Critical Care Medicine Nagoya University Hospital pp.746-752
Published Date 2019/10/1
DOI https://doi.org/10.11477/mf.3102200688
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In patients with epiglottitis, there are problems besides a difficult airway such as limitation of posture in the sitting position, agitated mental status, preserved reflex. To overcome these problems, the following strategy is proposed in this article. Primary choice of airway management procedure is awake nasal fiberoptic intubation. During this procedure the patient should be able to be calm and breathe spontaneously with intravenous administration of fentanyl. If it is unsuccessful, the next best methods include normal tracheal intubation after rapid sequence intubation (RSI) or cricothyroidotomy after RSI. An alternative method is the combination of using a tracheal tube as a supraglottic airway and tracheostomy under local anesthesia. With a tracheal tube functioning as a nasolaryngeal airway keeping patency at the site of airway narrowing, the patient can be in the supine position. If all these attempts fail, the use of veno-venous extracorporeal membrane oxygenation should be considered.


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電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル

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