Saudi Journal of Anaesthesia

LETTERS TO EDITOR
Year
: 2019  |  Volume : 13  |  Issue : 2  |  Page : 164-

Comment on published article: Cannot intubate and cannot ventilate scenario in an infant for airway assessment


Sohan Lal Solanki, Jeson R Doctor 
 Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Jeson R Doctor
Department of Anaesthesiology, Critical Care and Pain, 2nd Floor, Operation Theatre Complex, Main Building, Tata Memorial Centre, Parel, Mumbai, Maharashtra
India




How to cite this article:
Solanki SL, Doctor JR. Comment on published article: Cannot intubate and cannot ventilate scenario in an infant for airway assessment.Saudi J Anaesth 2019;13:164-164


How to cite this URL:
Solanki SL, Doctor JR. Comment on published article: Cannot intubate and cannot ventilate scenario in an infant for airway assessment. Saudi J Anaesth [serial online] 2019 [cited 2020 Aug 6 ];13:164-164
Available from: http://www.saudija.org/text.asp?2019/13/2/164/254541


Full Text



Sir,

We read with interest the article by Mahfouz et al.[1] on cannot intubate cannot ventilate (CICV) scenario in an infant for airway assessment. We congratulate the authors for their successful management of CICV in this case. However, we have a few concerns regarding the management of this case.

This 6-month-old baby was brought to the hospital with difficulty in breathing and severe stridor, and having suprasternal and intercostal recessions with conducted sounds on auscultation. The child was not maintaining oxygen saturation above 90% with 4 L of oxygen. In such a condition, a preoperative computed tomography scan which can clearly show the airway anatomy and if facility is present, an added virtual bronchoscopy (VB) can obviate the need for airway assessment under general anesthesia. VB is a noninvasive, uncomplicated and reproducible method in patients with an indication for airway assessment and could be used clinically as a safer alternative.[2]

Airway guidelines for children are for an unanticipated difficult airway and not for anticipated difficult airway or lower airway obstruction as in the present case.[3]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Mahfouz AK, Al Hadifi T, Rashid M. Cannot intubate and cannot ventilate scenario in an infant for airway assessment. Saudi J Anaesth 2019;13:83-4.
2Adali F, Uysal A, Bayramoglu S, Guner NT, Yilmaz G, Cimilli T. Virtual and fiber-optic bronchoscopy in patients with indication for tracheobronchial evaluation. Ann Thorac Med 2010;5:104-9.
3Pawar DK, Doctor JR, Raveendra US, Ramesh S, Shetty SR, Divatia JV, et al. All India difficult airway association 2016 guidelines for the management of unanticipated difficult tracheal intubation in Paediatrics. Indian J Anaesth 2016;60:906-14.