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Difficult airway due to angioedema caused after 14 years of taking enalapril
Vía aérea difícil por angioedema causado tras 14 años tomando enalapril
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Laurens Acevedo, M. Peña, F. Clau Terré, R. Blasco Mariño" "autores" => array:4 [ 0 => array:3 [ "nombre" => "M." "apellidos" => "Laurens Acevedo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Peña" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "F." "apellidos" => "Clau Terré" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:4 [ "nombre" => "R." "apellidos" => "Blasco Mariño" "email" => array:1 [ 0 => "roblasc.rb@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Anestesiología, Hospital Universitario Vall d’Hebron, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Vía aérea difícil por angioedema causado tras 14 años tomando enalapril" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 664 "Ancho" => 750 "Tamanyo" => 55274 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">CT scan showing complete collapse of the tongue and adjacent tissues around the endotracheal tube.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 66-year-old man of African ancestry was admitted due to postoperative ankle infection. His medical history was significant for hypertension (Enalapril for the past 14 years). He had no allergies. He reported progressive edema of the upper lip and tongue, together with and dysphagia. This progressed to dyspnea and swelling of the tongue, with no itching or urticaria (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). He was transferred to the operation room to undergo awake fiberoptic nasotracheal intubation to secure the airway. Significant tongue swelling with highly friable tissue was observed. The collapse of the epiglottis obstructed the usual view of vocal cords (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). A CT scan ruled out an infectious etiology and showed no free space around the nasotracheal tube (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Blood samples showed normal serum tryptase levels and high D-dimer. Further lab tests showed normal C4 and C1-inhibitor values. Hereditary or acquired C1-inhibitor deficiency was ruled out.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authors’ contributions</span><p id="par0010" class="elsevierStylePara elsevierViewall">ML: Supervised data collection, took part in manuscript preparation, and took responsibility for the paper as a whole.</p><p id="par0015" class="elsevierStylePara elsevierViewall">MP: Contributed substantially to the revision of the manuscript.</p><p id="par0020" class="elsevierStylePara elsevierViewall">FC: Supervised data collection, contributed substantially to the revision and design of the manuscript.</p><p id="par0025" class="elsevierStylePara elsevierViewall">RB: Supervised data collection, took part in manuscript preparation, and took responsibility for the paper as a whole.</p><p id="par0030" class="elsevierStylePara elsevierViewall">All authors read and approved the final manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Authors’ contributions" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Laurens Acevedo M, Peña M, Clau Terré F, Blasco Mariño R. Vía aérea difícil por angioedema causado tras 14 años tomando enalapril. Rev Esp Anestesiol Reanim. 2022;69:60–61.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 636 "Ancho" => 750 "Tamanyo" => 64903 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Oral cavity occupied by swollen protruding tongue.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 634 "Ancho" => 750 "Tamanyo" => 48351 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Fibrobronchoscopy showing collapse of the epiglottis due to the swollen tongue, preventing the usual view of the glottis.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 664 "Ancho" => 750 "Tamanyo" => 55274 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">CT scan showing complete collapse of the tongue and adjacent tissues around the endotracheal tube.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006900000001/v1_202201270542/S2341192922000014/v1_202201270542/en/main.assets" "Apartado" => array:4 [ "identificador" => "70433" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006900000001/v1_202201270542/S2341192922000014/v1_202201270542/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000014?idApp=UINPBA00004N" ]
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