Open AccessAn Extubation Protocol for Angioedema
Author(s) -
Floyd Elizabeth,
Goldstein Nira A.,
Joks Rauno,
Mascaro Miguel,
Liaw Christine,
Dickson Bradley,
Varughese Denny,
Silverman Joshua
Publication year - 2017
Publication title -
oto open
Language(s) - English
Resource type - Journals
ISSN - 2473-974X
DOI - 10.1177/2473974x17691230
Subject(s) - medicine , angioedema , laryngoscopy , intubation , cuff , anesthesia , leak , surgery , dermatology , environmental engineering , engineering
Angioedema—nonpitting edema of the mucous membranes and skin—most commonly occurs as a complication from the use of angiotensin‐converting enzyme inhibitors. At our institution, the otolaryngology department has incorporated the use of the endotracheal tube cuff‐leak test and bedside direct laryngoscopy to aid in timing for extubation of angioedema patients. Prospective data collection of patients presenting to the emergency department with angioedema was performed. Of 76 patients with angioedema, 9 required fiberoptic intubation. Intubation was performed at a median of 73 hours (range, 44‐118). An endotracheal tube cuff‐leak test was performed in 7 patients prior to extubation, and bedside direct laryngoscopy was also performed in 3 of these 7 patients to document resolution of laryngeal edema. The use of the endotracheal tube cuff‐leak test and bedside direct laryngoscopy is an easy and inexpensive method to help determine eligibility for extubation in patients intubated for angioedema.