Complete airway obstruction relieved with bilateral chest compression in a morbidly obese patient with undiagnosed hypertrophic mucosa and severe edema of arytenoids

  • Roshdi R. Al-metwalli
  • Hitham MA Elsayed
  • Alaa M. Khidr
  • Summayah M. Fallata
  • Maha SA Abdelhadi
DOI: https://doi.org/10.35975/apic.v26i2.1827
Keywords: Morbid obesity, Cardiopulmonary Resuscitation / methods, Chest Compression, Airway Obstruction / etiology, Humans, Treatment Outcome

Abstract

We describe a case of 62 y old obese lady, with undiagnosed hypertrophic mucosa and severe edema of the arytenoid cartilages. This swollen mucosal fold got pushed into the laryngeal inlet after insertion of laryngeal mask airway (LMA), causing complete airway obstruction and eventually a ‘can’t intubate, can’t ventilate’ (CICV) crisis situation. We describe how we did succeed to restore patient’s ventilation, in a CICV scenario with an unconventional way using chest compression avoiding the use of ultimate surgical airway. This is the first reported case of a chest compression maneuver being used as a rescue technique in a CICV scenario.

Abbreviation: BMI -  body mass index; LMA - Laryngeal mask airway; CICV - Can’t intubate, can’t ventilate; DM -  Diabetes mellitus; BA - bronchial asthma; GD - Graves ‘disease; GERD - Gastro-esophageal reflux disease; OSA - Obstructive sleep apnea; BMV - Bag-mask ventilation; DMV - Difficult mask ventilation; TV - tidal volume

Key words: Morbid obesity; Cardiopulmonary Resuscitation / methods; Chest Compression; Airway Obstruction / etiology; Humans; Treatment Outcome

Citation: Al-metwalli RR, Elsayed HMA, Khidr AM, Fallata SM, Abdelhadi MSA. Complete airway obstruction relieved with bilateral chest compression in a morbidly obese patient with undiagnosed hypertrophic mucosa and severe edema of arytenoids. Anaesth. pain intensive care 2022;26(2): 246–248; DOI: 10.35975/apic.v26i2.1827

Received: December 15, 2021, Reviewed: January 10, 2022, Accepted: January 30, 2022    

Author Biographies

Roshdi R. Al-metwalli

Roshdi R. Al-metwalli, Professor of Anesthesia & Intensive Care, Imam Abdulrahman Bin Faisal University, PO Box 40081, Al-Khobar-31952, Saudi Arabia

Hitham MA Elsayed

Hitham MA Elsayed, Lecturer, Department of Anesthesia & Intensive Care, Sohag University, Egypt

Alaa M. Khidr

Assistant Professor, Department of Anesthesia & Intensive Care, Imam Abdulrahman Bin Faisal University, PO Box 40081, Al-Khobar-31952, Saudi Arabia

Summayah M. Fallata

Assistant Professor, Department of Anesthesia & Intensive Care, Imam Abdulrahman Bin Faisal University, PO Box 40081, Al-Khobar-31952, Saudi Arabia

Maha SA Abdelhadi

Professor, Department of Surgery, Imam Abdulrahman Bin Faisal University, PO Box 40081, Al-Khobar-31952, Saudi Arabia

Published
04-15-2022
How to Cite
Al-metwalli, R., Elsayed, H., Khidr, A., Fallata, S., & Abdelhadi, M. (2022). Complete airway obstruction relieved with bilateral chest compression in a morbidly obese patient with undiagnosed hypertrophic mucosa and severe edema of arytenoids. Anaesthesia, Pain & Intensive Care, 26(2), 246-248. https://doi.org/10.35975/apic.v26i2.1827
Issue
Vol 26 No 2 (2022): April 2022
Section
Case Reports