Total views : 328

Obese and Tracheostomy Tube:Does one Size Fit All?

Affiliations

  • Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi – 110029, India

Abstract


Securing airway in obese patients is always challenging and sometimes it is extremely difficult when associated with other difficult airway factors. However, the procedure itself is associated with various complications like subcutaneous emphysema. The present case report describes the airway management in an obese patient on mechanical ventilation that developed subcutaneous emphysema on the second day following percutaneous tracheostomy using a standard length tracheostomy tube.

Keywords

Difficult Airway, Subcutaneous Emphysema, Tracheostomy.

Full Text:

 |  (PDF views: 130)

References


  • Dempsey GA, Grant CA, Jones TM. Percutaneous tracheostomy: a 6 yr prospective evaluation of the single tapered dilator technique. Br J Anaesth 2010;105:782–8.
  • Goldenberg D, Bhatti N. Management of the impaired airway in the adult. In: Cummings CW, editor. Otolaryngology Head and Neck Surgery. 4th ed. Philadelphia: Mosby; 2005. p. 2441–53.
  • Fikkers BG, van Veen JA, Kooloos JG, Pickkers P, van den Hoogen FJ, Hillen B, et al. Emphysema and pneumothorax after percutaneous tracheostomy: case reports and an anatomic study. Chest 2004;125:1805– 14.
  • Mansharamani NG, Koziel H, Garland R, LoCicero J 3rd, Critchlow J, Ernst A. Safety of bedside percutaneous dilatational tracheostomy in obese patients in the ICU. Chest 2000;117:1426–9.
  • Byhahn C, Lischke V, Meininger D, Halbig S, Westphal K. Peri-operative complications during percutaneous tracheostomy in obese patients. Anaesthesia 2005;60:12–5.
  • El Solh AA, Jaafar W. A comparative study of the complications of surgical tracheostomy in morbidly obese critically ill patients. Crit Care 2007;11:R3.
  • Hess DR. Tracheostomy tubes and related appliances. Respir Care 2005;50:497–510.
  • Szeto C, Kost K, Hanley JA, Roy A, Christou N. A simple method to predict pretracheal tissue thickness to prevent accidental decannulation in the obese. Otolaryngol Head Neck Surg 2010;143:223–9.