A NOVEL METHOD OF INTUBATION USING A LARYNGEAL MASK AIRWAY AND A BRONCHOSCOPE IN A PREMATURE INFANT

International Journal of Innovative Medicine and Health Science, Volume 6, 2016, 5-8

Mark Greenberg, Sidney Merritt, Alyssa Brzenski

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ABSTRACT

We present a novel technique for securing an endotracheal tube after using a #1 Classic laryngeal mask airway (LMA) as a conduit for intubating the trachea of a premature infant.  During induction of anesthesia for inguinal hernia repair in an ex- 23-week infant, an unanticipated difficult airway was encountered. After several unsuccessful attempts of intubating via direct laryngoscopy, we placed the endotracheal tube (ETT) into the trachea using a fiberoptic bronchoscope through a #1 LMA.  A pediatric stylette, with Hytape TM wrapped around the distal tip, was then used as a plunger to safely and easily remove the LMA from the mouth while maintaining the ETT in proper position. This technique is applicable in cases of a difficult neonatal airway where even a #1, the smallest LMA, is used.

Keywords: difficult neonatal intubation, laryngeal mask airway, fiberoptic intubation, difficult intubation