HIGH-FLOW NASAL CANNULA POST-TRACHEAL EXTUBATION IN A CHILD WITH UPPER AIRWAY OBSTRUCTION: CASE REPORT

José Colleti Junior, Tâmara Eleamen Longui, Werther Brunow de Carvalho, José Colleti Junior, Tâmara Eleamen Longui, Werther Brunow de Carvalho

Abstract

Objective: To report a case of a patient who required tracheal intubation in a pediatric emergency department due to acute laryngitis and that, after the planned extubation, has successfully used the high-flow nasal cannula, which possibly prevented extubation failure.

Case description: A male 8-month-old child was admitted to the pediatric emergency room with acute respiratory distress due to a high airway obstruction secondary to severe acute laryngitis. He was immediately intubated and referred to the pediatric intensive care unit. He presented extubation failure due to a significant laryngeal edema evidenced by bronchoscopy. In the second attempt to extubate, he presented respiratory distress, but, after the use of the high-flow nasal cannula, he became stable, reducing the heart and respiratory frequencies, and the extubation was successful.

Comments: The use of the high-flow nasal cannula was effective and presented good response in this patient with acute laryngitis, suggesting that it is a possible adjuvant for the treatment, avoiding worsening respiratory conditions and the need for reintubation.

Conflict of interest statement

Conflict of interests: The authors declare no conflict of interests.

Figures

Chart 1:. Westley’s scale for the clinical…
Chart 1:. Westley’s scale for the clinical evaluation of acute laryngitis.
Figure 1:. Bronchoscopy image showing mucosal edema…
Figure 1:. Bronchoscopy image showing mucosal edema (arrow) involving the orotracheal cannula and the enteral probe.
Figure 2:. Reduction of heart rate and…
Figure 2:. Reduction of heart rate and respiratory frequency after the use of high-flow nasal cannula (dotted arrow).

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Source: PubMed

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