ProSeal laryngeal mask airway for cardiac surgery after airway rescue

Abstract

We present the case of the successful use of a ProSeal™ laryngeal mask airway in a severe obese 41-year-old women with a difficult airway, scheduled to undergo cardiac surgery (off-pump coronary artery bypass). Two intubation attempts failed and face mask ventilation became impossible with rapidly falling peripheral oxygen saturation. A ProSeal™ laryngeal airway was railroaded over a tracheal tube guide, a gastric tube was inserted along the drain tube and the patient underwent positive pressure ventilation, resulting in normal gas exchange and an oropharyngeal leak pressure > 40 cm H 20. The decision was taken to proceed with the ProSeal™ as the airway during the surgical intervention. Surgery was uneventful and the ProSeal™ was removed on the ICU three hours later. This case reports illustrates the successful use of a guided insertion of the ProSeal™ laryngeal mask for airway rescue in cardiac surgery