Elective awake intubation in a patient with massive multinodular goitre presenting for radioiodine treatment.
We present the management of the potential airway complications in a case of massive multinodular goitre treated with radioactive iodine. The patient's trachea was prophylactically intubated, using a fibreoptic technique, to prevent further airway compromise due to thyroid oedema following radioactive iodine treatment. He remained awake and intubated for five days and was extubated when there was no clinical evidence of thyroid oedema as a consequence of his treatment. This approach avoided the considerable risk of thyroidectomy in a morbidly obese patient with airway obstruction. To the authors' knowledge this approach has not been previously described.
Chakera
A
A
Intensive Care Unit, Sir Charles Gairdner Hospital, Perth, WA, Australia.
van Heerden
P V
PV
van der Schaaf
A
A
D000402:Airway Obstruction / Q000209:etiology; D004487:Edema / Q000209:etiology; D006044:Goiter, Nodular / Q000150:complications / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications; D013961:Thyroid Gland / Q000473:pathology; D014135:Tracheal Stenosis / Q000209:etiology
D007457:Iodine Radioisotopes