Anesth Pain Med.  2020 Oct;15(4):505-509. 10.17085/apm.20043.

A novel application of Transnasal Humidified Rapid Insufflation Ventilatory Exchange via the oral route in morbidly obese patient during monitored anesthesia care - A case report -

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea

Abstract

Background
Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) is used to improve oxygenation, with the added benefit of a smaller increase in CO2 if self-respiration is maintained with THRIVE. Despite these advantages, the use of THRIVE through a nasal cannula is limited in situations such as epistaxis or a basal skull fracture. Case We successful used THRIVE, through the oral route under general anesthesia with spontaneous breathing in a morbidly obese patient (weight, 148 kg; height, 183 cm; body mass index, 44.2 kg/m2) who received transnasal steroid injections due to subglottic stenosis.
Conclusions
THRIVE through the oral route may be an effective novel option, although further studies are needed.

Keyword

Airway management; Balanced anesthesia; Obesity, morbid; Otolaryngologic disorders

Figure

  • Fig. 1. (A) End-tidal CO2 (EtCO2) at nostril. (B) EtCO2 at oral airway. (C) Desaturation event.

  • Fig. 2. (A) Oral airway, (B) Optiflow nasal cannula, (C) EtCO2 sample line. EtCO2: end-tidal CO2.


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