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Our Experience with EXIT Procedures: A Case Series.

Darshil Vaishnav1,2, Sachin Gandhi1, Snehpali Bansode1

  • 1Deenanath Mangeshkar Hospital, Pune, India.

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|November 19, 2024
PubMed
Summary

The Ex-Utero Intra Partum Procedure (EXIT) is vital for neonates with congenital airway obstructions, enabling successful airway management and improved outcomes in emergency situations.

Keywords:
CHAOSDifficult intubationEXIT procedureNeonatal airwayPediatric tracheostomyPolyhydramnios

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Area of Science:

  • Neonatal Medicine
  • Surgical Innovation
  • Obstetrics

Background:

  • Neonatal respiratory distress requires immediate airway management.
  • Congenital airway obstructions pose significant challenges.
  • The Ex-Utero Intra Partum Procedure (EXIT) offers a potential solution.

Purpose of the Study:

  • To explore the utility of the EXIT procedure in managing neonatal airway emergencies.
  • To present case series of EXIT tracheostomy for congenital airway obstructions.
  • To highlight the importance of multidisciplinary teams and planning.

Main Methods:

  • Case series review of two neonates undergoing EXIT procedures.
  • EXIT tracheostomy performed for micrognathia and Congenital High Airway Obstruction Syndrome (CHAOS).
  • Focus on maintaining fetal oxygenation via utero-placental circulation during the procedure.

Main Results:

  • Successful EXIT tracheostomy achieved in both cases, resolving airway obstruction.
  • Neonatal oxygenation maintained throughout the procedure via placental support.
  • Demonstrated feasibility in preterm infants with complex airway issues.

Conclusions:

  • The EXIT procedure is a critical intervention for neonates with congenital airway obstructions.
  • Early prenatal diagnosis, meticulous planning, and multidisciplinary collaboration are essential.
  • The EXIT procedure ensures optimal maternal and neonatal outcomes in emergency airway management.