Rigid bronchoscope-assisted endotracheal intubation: yet another use of the gum elastic bougie.
We describe a technique by which a gum elastic bougie (GEB) is used to facilitate an anticipated difficult endotracheal intubation in a patient undergoing rigid bronchoscopy. After placing the GEB through the lumen of the rigid bronchoscope, the GEB-suction catheter assembly was used to safely withdraw the bronchoscope in a manner mimicking the withdrawal of an intubating laryngeal mask airway (LMA) over the endotracheal tube using a stabilizer rod. The rationale for management and potential advantages of this approach versus use of an airway exchange catheter (including increased stability of an intubation guide) are discussed.


CONCLUSIONS
We describe a technique of using a gum elastic bougie to facilitate an endotracheal intubation in a patient undergoing rigid bronchoscopy, which can be useful in a variety of clinical situations when the rigid bronchoscope is used in patients with abnormal airway.
Nekhendzy
Vladimir
V
Department of Anesthesia, Stanford University, California.
Simmonds
Paul K
PK
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications; D001999:Bronchoscopy; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D017214:Laryngeal Masks; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008297:Male; D012121:Respiration, Artificial