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Aortic injury and physiologically difficult airway: A case report

Year: 2025

Type: article

Abstract: Blunt thoracic trauma can lead to aortic dissection and a physiologically difficult airway. Early thoracic endovascular aortic repair (TEVAR) is recommended under general anesthesia and can be complicated by peri-intubation adverse events. We report a 33-year-old male with a thoracic aortic injury who developed oxygen desaturation and severe hypotension during anesthetic induction and tracheal intubation before TEVAR. Imaging revealed an expanding left hemothorax, and he was revived with mechanical ventilation, nor-adrenaline, blood transfusion, aortic stenting, and evacuation of left hemothorax. Post-operative care was continued in the trauma intensive care unit. He was extubated uneventfully two days later and discharged from the hospital after a further 8 days. Despite the patient not being elderly or emergently intubated for critical illness, many recommendations from the INTUBE study for the management of a physiologically difficult airway may hold relevance, such as first-pass intubation success, intubation by consultant anesthetist, use of video-laryngoscope, and non-use of propofol for induction. Risk assessment and maintenance of oxygenation and organ perfusion remain paramount.

Source: JCA advances.

DOI: 10.1016/j.jcadva.2025.100108

Authors: Muhammad Jaffar Khan, Temur Baykuziyev, Arunabha Karmakar, Mogahed Ismail Hassan Hussein, Yasir Eltiraifi Ahmed

Institution: Hamad Medical Corporation

Language: English

Topic: Airway Management and Intubation Techniques

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,200