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April 11, 2026Clinical and Experimental Emergency Medicine0 citationsOpen Access

Hemodynamically Neutral Intubation in Massive Pulmonary Embolism: Management of a Physiologically Difficult Airway – a case report

SKStefan KornstaedtAPAishwarya PalaniappanMWMaximilian Weinhofer

Key Points

  • To explore a technique for intubation that minimizes hemodynamic risks in patients with massive pulmonary embolism and right ventricular failure.
  • Described management of a critically ill patient with massive pulmonary embolism and right ventricular failure.
  • Utilized hemodynamically neutral intubation techniques to preserve spontaneous ventilation.
  • Monitored hemodynamic parameters during and after intubation.
  • Successful intubation was achieved without causing hemodynamic deterioration.
  • Spontaneous negative-pressure ventilation was preserved throughout the procedure.
  • The technique contributed to stable cardiovascular function in a peri-arrest patient.

Abstract

What is already knownIntubation of critically ill patients with right ventricular failure or massive pulmonary embolism is associated with a high risk of hemodynamic deterioration and cardiovascular collapse, particularly related to sedative agents and positive-pressure ventilation. What is new in the current studyThis case shows that hemodynamically neutral intubation with preservation of spontaneous negativepressure ventilation can be performed without hemodynamic deterioration in a peri-arrest patient with massive pulmonary embolism. Ethical

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Cite This Study

Kornstaedt et al. (2026) studied this question.

synapsesocial.com/papers/69d9e63478050d08c1b768bfhttps://doi.org/10.15441/ceem.26.064
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