• Ji-Yoon Kim, Jieun Bae, Kwang Hyun Lee, Leekyeong Kang, Kyu Nam Kim, and Mi Ae Jeong.
• Department of Anesthesiology and Pain Medicine, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Republic of Korea.
• Medicine (Baltimore). 2021 Dec 10; 100 (49): e28102e28102.

RationaleLaryngomalacia is defined as the collapse of supraglottic structures and can cause not only strider but also trigger difficulties with ventilation and endotracheal intubation during anesthesia management. High-flow nasal cannula (HFNC) has been used to manage patients at high risk of hypoxemia in the intensive care unit; however, limited literature information is available for the application of HFNC to infant patients with laryngomalacia during anesthesia practice.Patient ConcernsA 2-month-old male infant was scheduled to undergo surgery for inguinal hernia and undescended testis with general anesthesia.DiagnosisThe patient had subcostal retraction while breathing and frequent oxygen desaturation events and was diagnosed laryngomalacia.InterventionsAfter the patient was supplied oxygen via HFNC and then given general anesthesia, the initial 2 attempts of endotracheal intubation with a rigid laryngoscope were unsuccessful because the vocal cords were obscured by the epiglottis. A third intubation attempt was performed and successful with a 3.0-sized, uncuffed endotracheal tube within 20 minutes of the initial attempt.OutcomesNo airway complications emerged and oxygen saturation remained at greater than 98% during general anesthesia. The patient was discharged 5 days after surgery without any adverse side effects.LessonsContinuous oxygenation via HFNC is a good choice to prevent desaturation during difficult tracheal intubations in infant patients with laryngomalacia. This device is expected to be useful for intubation not only in patients with laryngomalacia, but also in infant patients with a predicted high risk of oxygen desaturation events during general anesthesia.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

22 keywords...

hide…