title: [Anesthetic management using veno-veno bypass for emergent tracheostomy in a patient with acute epiglottitis].
abstract: We report anesthetic management using veno-veno bypass (V-V bypass) for emergent tracheostomy in a patient with acute epiglottitis. A 72-year-old woman complained of dyspnea due to acute epiglottitis, and emergent tracheostomy was planned for her. Since physical and optical fiberscopic examinations indicated a high risk of airway collapse during anesthetic induction, we planned to do tracheostomy under V-V bypass in order to maintain oxygenation. V-V bypass was established using the right femoral and jugular veins in an awake condition. After starting V-V bypass, tracheostomy was performed under intravenous propofol anesthesia. During surgery, bispectral index was maintained below 60. Surgery was carried out with ease and uneventfully. The patient had no complications due to V-V bypass postoperatively.
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo 060-8543.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sawada
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kawamata
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Namiki
mesh_terms: D000208:Acute Disease; D000368:Aged; D000771:Anesthesia, Intravenous; D004630:Emergencies; D004826:Epiglottitis / Q000601:surgery*; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D005268:Femoral Vein; D006801:Humans; D007601:Jugular Veins; D014139:Tracheostomy