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Severe gastric insufflation and consequent atelectasis caused by gas leakage using AIR-Q laryngeal mask airway: A case report

BACKGROUND: The airways of patients undergoing awake craniotomy (AC) are considered “predicted difficult airways”, inclined to be managed with supraglottic airway devices (SADs) to lower the risk of coughing or gagging. However, the special requirements of AC in the head and neck position may deteri...

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Autores principales: Zhao, Yue, Li, Ping, Li, De-Wei, Zhao, Gao-Feng, Li, Xiang-Yu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9048551/
https://www.ncbi.nlm.nih.gov/pubmed/35582056
http://dx.doi.org/10.12998/wjcc.v10.i11.3541
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author Zhao, Yue
Li, Ping
Li, De-Wei
Zhao, Gao-Feng
Li, Xiang-Yu
author_facet Zhao, Yue
Li, Ping
Li, De-Wei
Zhao, Gao-Feng
Li, Xiang-Yu
author_sort Zhao, Yue
collection PubMed
description BACKGROUND: The airways of patients undergoing awake craniotomy (AC) are considered “predicted difficult airways”, inclined to be managed with supraglottic airway devices (SADs) to lower the risk of coughing or gagging. However, the special requirements of AC in the head and neck position may deteriorate SADs’ seal performance, which increases the risks of ventilation failure, severe gastric insufflation, regurgitation, and aspiration. CASE SUMMARY: A 41-year-old man scheduled for AC with the asleep–awake–asleep approach was anesthetized and ventilated with a size 3.5 AIR-Q intubating laryngeal mask airway (LMA). Air leak was noticed with adequate ventilation after head rotation for allowing scalp blockage. Twenty-five minutes later, the LMA was replaced by an endotracheal tube because of a change in the surgical plan. After surgery, the patient consistently showed low tidal volume and was diagnosed with gastric insufflation and atelectasis using computed tomography. CONCLUSION: This case highlights head rotation may cause gas leakage, severe gastric insufflation, and consequent atelectasis during ventilation with an AIR-Q intubating laryngeal airway.
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spelling pubmed-90485512022-05-16 Severe gastric insufflation and consequent atelectasis caused by gas leakage using AIR-Q laryngeal mask airway: A case report Zhao, Yue Li, Ping Li, De-Wei Zhao, Gao-Feng Li, Xiang-Yu World J Clin Cases Case Report BACKGROUND: The airways of patients undergoing awake craniotomy (AC) are considered “predicted difficult airways”, inclined to be managed with supraglottic airway devices (SADs) to lower the risk of coughing or gagging. However, the special requirements of AC in the head and neck position may deteriorate SADs’ seal performance, which increases the risks of ventilation failure, severe gastric insufflation, regurgitation, and aspiration. CASE SUMMARY: A 41-year-old man scheduled for AC with the asleep–awake–asleep approach was anesthetized and ventilated with a size 3.5 AIR-Q intubating laryngeal mask airway (LMA). Air leak was noticed with adequate ventilation after head rotation for allowing scalp blockage. Twenty-five minutes later, the LMA was replaced by an endotracheal tube because of a change in the surgical plan. After surgery, the patient consistently showed low tidal volume and was diagnosed with gastric insufflation and atelectasis using computed tomography. CONCLUSION: This case highlights head rotation may cause gas leakage, severe gastric insufflation, and consequent atelectasis during ventilation with an AIR-Q intubating laryngeal airway. Baishideng Publishing Group Inc 2022-04-16 2022-04-16 /pmc/articles/PMC9048551/ /pubmed/35582056 http://dx.doi.org/10.12998/wjcc.v10.i11.3541 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Case Report
Zhao, Yue
Li, Ping
Li, De-Wei
Zhao, Gao-Feng
Li, Xiang-Yu
Severe gastric insufflation and consequent atelectasis caused by gas leakage using AIR-Q laryngeal mask airway: A case report
title Severe gastric insufflation and consequent atelectasis caused by gas leakage using AIR-Q laryngeal mask airway: A case report
title_full Severe gastric insufflation and consequent atelectasis caused by gas leakage using AIR-Q laryngeal mask airway: A case report
title_fullStr Severe gastric insufflation and consequent atelectasis caused by gas leakage using AIR-Q laryngeal mask airway: A case report
title_full_unstemmed Severe gastric insufflation and consequent atelectasis caused by gas leakage using AIR-Q laryngeal mask airway: A case report
title_short Severe gastric insufflation and consequent atelectasis caused by gas leakage using AIR-Q laryngeal mask airway: A case report
title_sort severe gastric insufflation and consequent atelectasis caused by gas leakage using air-q laryngeal mask airway: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9048551/
https://www.ncbi.nlm.nih.gov/pubmed/35582056
http://dx.doi.org/10.12998/wjcc.v10.i11.3541
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