Northern Journal of ISA

Vikas Chauhan ¹, Gyaninder Pal Singh ¹, Ashish Bindra ¹, Niraj Kumar ¹

Affiliations
1 Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi – 110029, IN

Abstract

Securing airway in obese patients is always challenging and sometimes it is extremely difficult when associated with other difficult airway factors. However, the procedure itself is associated with various complications like subcutaneous emphysema. The present case report describes the airway management in an obese patient on mechanical ventilation that developed subcutaneous emphysema on the second day following percutaneous tracheostomy using a standard length tracheostomy tube.

Keywords

Difficult Airway, Subcutaneous Emphysema, Tracheostomy.

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Sandeep Kumar ¹, Varun Jain ¹, Keshav Goyal ¹, Shweta Kedia ², Ashish Bindra ¹, Girija Prasad Rath ¹

Affiliations
1 Department of Neuroanaesthesiology and Critical Care, AIIMS, New Delhi, IN
2 Department of Neurosurgery, AIIMS, New Delhi, IN

Abstract

Huge hydrocephalus (head circumference greater than infant's height) is a rare entity. Intraoperative management in children is challenging for both surgery and anaesthesia owing to the altered anatomy and underlying pathophysiology. Increase in Intracranial Pressure (ICP) in these children may lead to herniation, respiratory and cardiac arrest, and possibly, death. Here, we report the largest reported case of hydrocephalus and associated intraoperative challenges.

Keywords

Anaesthesia, Congenital Hydrocephalus, Huge Hydrocephalus, Infant, Management.

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