Neočekivana otežana ekstubacija zbog mehaničkih uzroka nakon parotidektomije: prikaz bolesnice

Dinko Tonković, Martina Miklić Bublić, Daniela Bandić Pavlović, Ante Sekulić, Igor Balenović, Slobodan Mihaljević, Renata Curić Radivojević, Robert Baronica

Termin otežani dišni put odnosi se na teškoće pri intubaciji i ekstubaciji. U ovom radu prikazujemo otežanu ekstubaciju i postupak zbrinjavanja dišnog puta u bolesnice nakon učinjene parotidektomije. Iako postoje smjernice za otežani dišni put, ne postoje jasne upute za mehanički uzrokovanu otežanu ekstubaciju kada se endotrahealni tubus ne može izvaditi. Takva stanja rijetko se spominju u literaturi, obično u obliku prikaza bolesnika. Nemogućnost vađenja endotrahealnog tubusa zbog mehaničkih uzroka hitno je stanje, stoga nalaže izradu smjernica i algoritma postupanja. Algoritam koji smo rabili u ovom slučaju protekao je bez komplikacija i bolesnica se dobro oporavila.

Difficult airway management usually refers to intubation or extubation problems. We present a case report of difficult extubation, and airway management algorithm that was used in a female patient following parotidectomy. Although there are algorithms for difficult airway management, there are no recommendations for difficult extubation that is mechanically caused and where endotracheal tube cannot be easily removed. Such conditions are rarely mentioned in the literature,usually in the form of case reports. Inability to remove endotracheal tube due to mechanical causes is an urgent condition and calls for an algorithm and guidelines. The algorithm that was performed in this case went uneventfully, and the patient recovered well.