Use of a trans-tracheal rapid insufflation of oxygen device in a “cannot intubate, cannot oxygenate” scenario in a parturient-A case report

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Abstract

Background: The trans-tracheal rapid insufflation of oxygen (TRIO) device is less commonly used and is an alternative to trans-tracheal jet ventilation for maintaining oxygenation in a “cannot intubate, cannot oxygenate” (CICO) scenario. Case: We report the successful use of this device to maintain oxygenation after jet ventilator failure in a parturient who presented with the CICO scenario during the procedure for excision of laryngeal papilloma. Conclusions: A stepwise approach to the airway plan and preparation for an event of failure is essential for good mater-no-fetal outcomes. The TRIO device may result in inadequate ventilation that can lead to hypercarbia and respiratory acidosis. Hence, it should only be used as a temporizing measure before a definitive airway can be secured.

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Lee, J., Ng, V. V., Teo, C., & Wong, P. (2019). Use of a trans-tracheal rapid insufflation of oxygen device in a “cannot intubate, cannot oxygenate” scenario in a parturient-A case report. Korean Journal of Anesthesiology, 72(4), 375–380. https://doi.org/10.4097/kja.d.18.00118

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