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Case Reports in Anesthesiology
Volume 2012 (2012), Article ID 592198, 3 pages
http://dx.doi.org/10.1155/2012/592198
Case Report

Impossible Airway Requiring Venovenous Bypass for Tracheostomy

Department of Anesthesiology, Montefiore Medical Center, Bronx, New York City, NY 10467, USA

Received 26 June 2012; Accepted 29 July 2012

Academic Editors: J. J. Derose, M. Kodaka, and M. Marandola

Copyright © 2012 Johnathan Gardes and Tracey Straker. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The elective surgical airway is the definitive management for a tracheal stenotic lesion that is not a candidate for tracheal resection, or who has failed multiple-tracheal dilations. This case report details the management of a patient who has failed an elective awake tracheostomy secondary to the inability to be intubated as well as severe scar tissue at the surgical site. A combination of regional anesthesia and venovenous bypass is used to facilitate the surgical airway management of this patient. Cerebral oximetry and a multidisciplinary team approach aid in early detection of an oxygenation issue, as well as the emergent intervention that preserved this patient’s life.