Life-threatening airway obstruction due to upper airway edema and marked neck swelling after labor and delivery
Background and objectives: Airway changes generally occur in normal gravidas; however, these changes could cause critical situations in specific populations. Objectives: This article presents the case of a difficult airway patient that went into shock because of atonic bleeding after vaginal deliver...
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doaj-6987322610c640b797b26322db60a43c2020-11-24T22:08:59ZengElsevierBrazilian Journal of Anesthesiology0104-00142013-11-01636508510Life-threatening airway obstruction due to upper airway edema and marked neck swelling after labor and deliveryJunko Ushiroda0Satoki Inoue1Junji Egawa2Yasunobu Kawano3Masahiko Kawaguchi4Hitoshi Furuya5Department of Anesthesiology, Nara Medical University, Kashihara, JapanDepartment of Anesthesiology, Nara Medical University, Kashihara, Japan; Corresponding author.Department of Anesthesiology, Nara Medical University, Kashihara, JapanDivision of Intensive Care, Nara Medical University, Kashihara, JapanDepartment of Anesthesiology, Nara Medical University, Kashihara, JapanDepartment of Anesthesiology, Nara Medical University, Kashihara, JapanBackground and objectives: Airway changes generally occur in normal gravidas; however, these changes could cause critical situations in specific populations. Objectives: This article presents the case of a difficult airway patient that went into shock because of atonic bleeding after vaginal delivery for stillbirth. Case report: A 32-yr-old woman with atonic bleeding after vaginal delivery for stillbirth was transferred to our hospital. She manifested shock, and her respiratory condition was progressively deteriorating. Airway obstruction caused by neck swelling and pharyngolaryngeal edema was apparent. We tried tracheal intubation using direct and indirect laryngoscopes. However, it turned out that insertion of the laryngoscopic devices to the oral cavity was impossible. After several attempts using the Trachlight™, successful intubation was finally made. After hysterectomy, she was admitted to the intensive care unit (ICU) and treated for five days. At discharge from the ICU, her Mallampati score was I-II. Her body weight decreased 60 kg to 51 kg during ICU stay. Conclusions: We believe that concomitant attacks of labor and delivery and fluid resuscitation probably worsened upper airway and neck edema enough to cause acute airway obstruction and difficult laryngoscopy. Keywords: Labor and delivery, Difficult airway, Airway edemahttp://www.sciencedirect.com/science/article/pii/S010400141300119X |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Junko Ushiroda Satoki Inoue Junji Egawa Yasunobu Kawano Masahiko Kawaguchi Hitoshi Furuya |
spellingShingle |
Junko Ushiroda Satoki Inoue Junji Egawa Yasunobu Kawano Masahiko Kawaguchi Hitoshi Furuya Life-threatening airway obstruction due to upper airway edema and marked neck swelling after labor and delivery Brazilian Journal of Anesthesiology |
author_facet |
Junko Ushiroda Satoki Inoue Junji Egawa Yasunobu Kawano Masahiko Kawaguchi Hitoshi Furuya |
author_sort |
Junko Ushiroda |
title |
Life-threatening airway obstruction due to upper airway edema and marked neck swelling after labor and delivery |
title_short |
Life-threatening airway obstruction due to upper airway edema and marked neck swelling after labor and delivery |
title_full |
Life-threatening airway obstruction due to upper airway edema and marked neck swelling after labor and delivery |
title_fullStr |
Life-threatening airway obstruction due to upper airway edema and marked neck swelling after labor and delivery |
title_full_unstemmed |
Life-threatening airway obstruction due to upper airway edema and marked neck swelling after labor and delivery |
title_sort |
life-threatening airway obstruction due to upper airway edema and marked neck swelling after labor and delivery |
publisher |
Elsevier |
series |
Brazilian Journal of Anesthesiology |
issn |
0104-0014 |
publishDate |
2013-11-01 |
description |
Background and objectives: Airway changes generally occur in normal gravidas; however, these changes could cause critical situations in specific populations. Objectives: This article presents the case of a difficult airway patient that went into shock because of atonic bleeding after vaginal delivery for stillbirth. Case report: A 32-yr-old woman with atonic bleeding after vaginal delivery for stillbirth was transferred to our hospital. She manifested shock, and her respiratory condition was progressively deteriorating. Airway obstruction caused by neck swelling and pharyngolaryngeal edema was apparent. We tried tracheal intubation using direct and indirect laryngoscopes. However, it turned out that insertion of the laryngoscopic devices to the oral cavity was impossible. After several attempts using the Trachlight™, successful intubation was finally made. After hysterectomy, she was admitted to the intensive care unit (ICU) and treated for five days. At discharge from the ICU, her Mallampati score was I-II. Her body weight decreased 60 kg to 51 kg during ICU stay. Conclusions: We believe that concomitant attacks of labor and delivery and fluid resuscitation probably worsened upper airway and neck edema enough to cause acute airway obstruction and difficult laryngoscopy. Keywords: Labor and delivery, Difficult airway, Airway edema |
url |
http://www.sciencedirect.com/science/article/pii/S010400141300119X |
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