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Case Rep Anesthesiol. 2012;2012:592198. doi: 10.1155/2012/592198. Epub 2012 Aug 16.

Impossible airway requiring venovenous bypass for tracheostomy.

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  • 1Department of Anesthesiology, Montefiore Medical Center, Bronx, New York City, NY 10467, USA.


The elective surgical airway is the definitive management for a tracheal stenotic lesion that is not a candidate for tracheal resection, or who has failed multiple-tracheal dilations. This case report details the management of a patient who has failed an elective awake tracheostomy secondary to the inability to be intubated as well as severe scar tissue at the surgical site. A combination of regional anesthesia and venovenous bypass is used to facilitate the surgical airway management of this patient. Cerebral oximetry and a multidisciplinary team approach aid in early detection of an oxygenation issue, as well as the emergent intervention that preserved this patient's life.

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