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Updated: Sep 25, 2026

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
High-flow nasal cannula in a patient with prolonged air leak following cardiothoracic surgery: A case-based
1Clinic of Cardiovascular Surgery, Dr. İsmail Fehmi Cumalıoğlu City Hospital, Tekirdağ, Türkiye.
Abstract:
Prolonged air leak (PAL) following cardiothoracic surgery severely limits available ventilatory strategies. We report a 68-year-old male who developed bilateral PAL after coronary artery bypass grafting and mitral valve replacement. Despite maximal ventilatory support, critical hypoxaemia persisted. Following early extubation at hour 72, high-flow nasal cannula (HFNC) was initiated, achieving rapid oxygenation recovery (ΔPaO2 +22 mmHg, ΔPaCO2 -15 mmHg within 24 hours). Combined with awake physiotherapy and intermittent noninvasive ventilation, HFNC facilitated clinical recovery without re-intubation. This case illustrates HFNC as a feasible respiratory support alternative when positive-pressure strategies are limited by PAL.
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