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Quick tip for families in ICU: Can a ventilated patient be extubated with airway swelling?

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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So we’re working with a client at the moment who has their mother in ICU with a breathing tube and on mechanical ventilation after cardiac arrest. Now, it looks like our client’s mother is coming close to having the breathing tube removed. She’s slowly waking up, she’s breathing on CPAP, she’s passing the spontaneous breathing trials, x-ray seems to be clear, arterial blood gases seem to be clear.

So she’s coming closer to being weaned off, to being extubated and having the breathing tube removed. There’s just one caveat. She’s got airway swelling and airway swelling basically means even though she can breathe spontaneously, as soon as the breathing tube comes out, the airway swells and somebody can’t breathe and they have to have the breathing tube either reinserted, which could be very difficult because of the swelling or number two, they have to have a tracheostomy because that would bypass the airway swelling.

So when there is airway swelling and the breathing tube can’t be removed, you need to look at treatment options such as steroids, like dexamethasone or methylprednisone and also adrenaline nebulizers or epinephrine nebulizers, that might help.

Continuation...
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