Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Deep Sedation in a Lung Transplant Candidate With Severe Cystic Fibrosis: A Case Report.

Abstract

Transnasal humidified rapid-insufflation ventilatory exchange is a recently described technique for safer management of difficult airways and a novel ventilation technique under anesthesia. Its full potential in patient safety and benefits are still being investigated. We describe the use of transnasal humidified rapid-insufflation ventilatory exchange for deep sedation during dental extractions in a patient with severe cystic fibrosis as a precondition for lung transplantation. Patient wanted to have the procedure under general anesthesia with intubation due to extreme anxiety. However, we advocated deep IV sedation with transnasal humidified rapid-insufflation ventilatory exchange. Oxygenation was maintained without airway obstruction and pulmonary complications during the entire procedure of 110 minutes.