Korean J Anesthesiol.  2019 Aug;72(4):381-384. 10.4097/kja.d.18.00334.

Use of a trans-tracheal rapid insufflation of oxygen device in a “cannot intubate, cannot oxygenate” scenario in a parturient: a case report

• Lee J
• Ng VV
• Teo C
• Wong P

• KMID: 2458324
• DOI: http://doi.org/10.4097/kja.d.18.00334

Abstract

BACKGROUND
The trans-tracheal rapid insufflation of oxygen (TRIO) device is less commonly used and is an alternative to trans-tracheal jet ventilation for maintaining oxygenation in a "cannot intubate, cannot oxygenate" (CICO) scenario. CASE: We report the successful use of this device to maintain oxygenation after jet ventilator failure in a parturient who presented with the CICO scenario during the procedure for excision of laryngeal papilloma.
CONCLUSIONS
A stepwise approach to the airway plan and preparation for an event of failure is essential for good materno-fetal outcomes. The TRIO device may result in inadequate ventilation that can lead to hypercarbia and respiratory acidosis. Hence, it should only be used as a temporizing measure before a definitive airway can be secured.

Keyword

Airway management; Airway obstruction; High-frequency jet ventilation; Insufflation; Obstetrical anesthesia; Trans-tracheal rapid insufflation of oxygen (TRIO)

MeSH Terms

Acidosis, Respiratory
Airway Management
Airway Obstruction
Anesthesia, Obstetrical
High-Frequency Jet Ventilation
Insufflation*
Oxygen*
Papilloma
Ventilation
Ventilators, Mechanical
Oxygen