Introduction: A key component of perioperative management of complicated cardiac procedure patients is the avoidance of airway and pulmonary complications during the postoperative period. The AnpanoGuardTM system (Hospitech Respiration Ltd.) plays an important role in reducing complications related to inappropriate cuff pressure and aspiration of subglottic secretions.
Case Presentation: A 64-year old patient presented for replacement of thoracic aorta due to aneurysm with dilation of up to 64 mm. In the OR, the patient was intubated with AG ETT and transferred to CICU where she was connected to AG100s device for protective airway management for 10d, 17h hours and 19m without complications. Cuff pressure was continuously monitored and managed by the system within preset pressure limits of 25-35cm H2O. Leak tests were performed automatically by the system; 22 leaks were detected and cuff pressure was auto-adjusted.
A total of 240cc of subglottic secretions were removed by the system during intubation.
The post-operative stay in CICU included left pleural effusion, addressed with pig-tail insertion.
Post-extubation chest X-ray showed normal lungs without consolidations; no significant throat pain was noted.
Conclusions: The AnapnoGuard™ system is an airway management device that provides continuous monitoring of leaks around the ETT cuff, cuff pressure monitoring and adjustment, as well as effective removal of subglottic secretions in mechanically ventilated patients. When using this device, we observed quantitative removal of secretions, continuous monitoring and adjustment of cuff pressure to the minimal pressure needed to completely seal the trachea, and successful avoidance of airway complications.
CXR from 08/23/2019 CXR from 09/09/2019
Co2 leaks readings during the intubation time
Secretions management Cuff pressure management