Opening of Tracheostomy in a Morbid Obese Patient With Frova Catheter

Abstract

Morbid obesity is defined as body mass index (BMI) at or over 40. Unfavorable neck anatomies of the patient are considered counter indication for percutaneous tracheostomy and they are referred for opening of surgical tracheostomy. In our case report, problems encountered in a morbid obese patient who could not be extubated due to post operative respiratory problems and the use of frova catheter (COOK, USA) in this procedure is discussed. A 42 old female patient at the weight of 246 kg. with BMI 89.4 could not be extubated due to respiratory causes post operatively and she was transferred to operating theater for surgical tracheostomy. After tracheostomy was opened, due to unsuitable anatomy associated with thick fat tissue on the neck the tracheostomy cannule couldn’t forwarded from tracheostomy hole, frova intubation catheter was sent and over it, 8 no endotracheal tube was sent in order to aerate the patient. Opening of tracheostomy in the morbidly obese is challenging operation due to specific anatomic conditions. Frova intubation guide helps in difficult intubation cases and was reported to be used for retrograde intubation in patients in whom antegrade intubation was not possible. In morbid obese patients, opening tracheostomy and then cannulating is difficult. Frova intubation guide can be used for difficult intubation in morbidly obese patients. In addition, as in the present case, it can be used in conditions in which tracheostomy cannula is too short or could not be placed during tracheostomy procedure.