Abstract
Use of intermittent ventilation in a patient with a left ventricular assist device (LVAD) and right heart dysfunction undergoing tracheal balloon dilation: A case report
Highlights
IntroductionThere are many airway management techniques and ventilatory strategies that Anesthesiologists may employ during tracheal balloon dilation, all of which come with their own benefits and risks, even in otherwise healthy patients
We report the successful use of intermittent ventilation as a management strategy to prevent hypoxic and hypercarbia pulmonary vasoconstriction
There are many airway management techniques and ventilatory strategies that Anesthesiologists may employ during tracheal balloon dilation, all of which come with their own benefits and risks, even in otherwise healthy patients
Summary
There are many airway management techniques and ventilatory strategies that Anesthesiologists may employ during tracheal balloon dilation, all of which come with their own benefits and risks, even in otherwise healthy patients. Since right heart function remains unsupported in LVAD patients, it is important to understand the pre-operative function of the right ventricle in order to inform overall anesthetic decisions that are made for the patient which include proper airway and ventilatory management [1]. A 50-year-old female admitted with suspected gastrointestinal bleeding and stridor was found to have moderate-severe tracheal stenosis on a CT scan Her past medical history included paroxysmal atrial fibrillation, ST-elevation myocardial infarction requiring 2 drug-eluting stents, complicated by refractory shock requiring placement of an LVAD for destination therapy. Her course was complicated by respiratory failure requiring prolonged intubation and tracheostomy, which was in place for approximately 2 months. The patient emerged uneventfully from anesthesia and recovered back in her ICU room
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