骨形成不全症患者の気道管理に鼻咽頭エアウェイと輪状甲状膜切開チューブの併用が有効であった1症例

Airway Management by Nasopharyngeal Airway and Cricothyroidotomy Tube in a Patient with Osteogenesis Imperfecta

要旨

　26歳，骨形成不全症の男性。心停止に対する蘇生後11日目に抜管したがただちに再挿管となり，抜管困難を呈した。鼻咽頭エアウェイと輪状甲状膜切開チューブを併用し抜管に成功した。抜管困難の原因は相対的巨舌および下顎骨骨折による咽頭浮腫が考えられた。輪状甲状膜切開は緊急時以外の気道確保に有用な可能性が示唆された。

　Post-extubation airway management can be difficult in patients with anatomical abnormalities in the neck and/or head. We describe a successful extubation with the use of a cricothyroidotomy tube in a patient with osteogenesis imperfecta. A 26-year-old man（height 100 cm, weight 19 kg）was admitted to the ICU after experiencing cardiac arrest. After three extubation attempts that were unsuccessful due to an upper-airway obstruction, the patient was successfully extubated with the use of a nasopharyngeal airway and a cricothyroidotomy tube, which functioned as an effective secondary airway route. Cricothyroidotomy can be useful in non-emergent airway management.