• Sou Hyun Lee, Eunyoung Cho, Ji Hoon Park, Jae Yun Lee, Ji Hee Hong, and Hyeji Han.
• Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea.
• Medicine (Baltimore). 2023 Aug 4; 102 (31): e34567e34567.

RationaleTransnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is used in tracheostomy but not in cases of airway obstruction. This case report explores the use of THRIVE for managing airway obstruction during tracheostomy in patients with subglottic and tracheal stenosis, thereby addressing the current knowledge gap and exploring its potential for airway management.Patient ConcernsA 63-year-old female with subglottic and tracheal stenoses underwent tracheostomy. Multiple attempts to establish a patent airway were unsuccessful, and oxygen saturation dropped to 56%.DiagnosisEndotracheal tube was directed toward the tracheal wall, causing airway obstruction.InterventionsTHRIVE was administered to the patient. Subsequently, the tube position was adjusted to enhance ventilation.OutcomesThe patient's oxygen saturation increased to 99%. The postoperative complications, including subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumopericardium, resolved. The patient was discharged on postoperative day 9.LessonsTHRIVE could be considered a temporary measure to enhance oxygenation before initiating a definitive treatment strategy.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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