Awake Intubation .
In 2007 This 945 lb. case was reported by Cleveland Clinic Anesthesiologists Dr. John Doyle and Dr. Andrew Zura , Rakmachandran M ,Lin J, Cyinski J B, Parker B, Marks T, Feldman M, Lorenz RR who appear to have the record for a published and peer reviewed case of Super Obese Airway management.
This massive 22 year old individual required a tracheostomy for hypercarbia with failed CPAP therapy was reported in the Journal of Clinical Anesthesia : 2007;19:367-369.
The management was carried out by an awake approach with , first an attempt at awake flexible Fiberoptic endotracheal tube placement , which failed to achieve the safe advancement of the endotracheal tube. This failure was caused by poor patient compliance and epistaxis. Then a size 5 Proseal Laryngeal Mask Airway was placed successfully and provided a passage way for a Flexible scope passage with an Aintree exchange catheter loaded on to it. The flexible scope was then removed and the 7.5 mm I.D. endotracheal tube was then passed over the Aintree catheter by a "railroading" technique.
The GlideScope was not attempted in this individual so its possible utility is not determined. GlideScope use in Massive obesity has been reported by Dr. John Doyle elsewhere .
This massive 22 year old individual required a tracheostomy for hypercarbia with failed CPAP therapy was reported in the Journal of Clinical Anesthesia : 2007;19:367-369.
The management was carried out by an awake approach with , first an attempt at awake flexible Fiberoptic endotracheal tube placement , which failed to achieve the safe advancement of the endotracheal tube. This failure was caused by poor patient compliance and epistaxis. Then a size 5 Proseal Laryngeal Mask Airway was placed successfully and provided a passage way for a Flexible scope passage with an Aintree exchange catheter loaded on to it. The flexible scope was then removed and the 7.5 mm I.D. endotracheal tube was then passed over the Aintree catheter by a "railroading" technique.
The GlideScope was not attempted in this individual so its possible utility is not determined. GlideScope use in Massive obesity has been reported by Dr. John Doyle elsewhere .
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