Abstract
High-flow nasal oxygen (HFNO) is a potentially life-saving adjunct in the emergency management of the obstructed airway. HFNO has multiple beneficial applications in critical care and respiratory support, but its use in emergency-obstructed airway management has not been defined. This case report describes spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen to successfully manage acute adult epiglottitis with rapidly progressing airway obstruction. Oxygenation, carbon dioxide levels, and airway patency were maintained, which facilitated endotracheal intubation while the patient was spontaneously breathing during general anesthesia. The application of HFNO can be extended to emergency airway obstruction.
Highlights
High-flow nasal oxygen (HFNO) is a potentially life-saving adjunct in the emergency management of the obstructed airway
Spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen (STRIVE Hi) is a new airway management technique combining the benefits of high-flow nasal oxygen (HFNO) with spontaneous ventilation
Acute adult epiglottitis is an emergency where immediate prognosis relates to the ability to provide controlled airway protection
Summary
High-flow nasal oxygen (HFNO) is a potentially life-saving adjunct in the emergency management of the obstructed airway. It has been shown to preserve airway patency, oxygenation, and carbon dioxide levels in elective cases with severe airway obstruction and respiratory compromise.[1] This is the first description of its use managing an airway emergency.
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