Challenges in extubating a COPD patient with respiratory failure and asymptomatic long standing multinodular goitre with retrosternal extension

Abstract

Upper airway obstruction by long standing multi nodular goitre is a challenge for anaesthetist due to tracheal compression and associated intubation and extubation problems. This case report is about the problems in extubating a COPD patient with long standing asymptomatic multinodular goitre. 60 years old female, known Diabetic, Hypertensive, Chronic obstructive pulmonary disease with thyroid swelling of 40 years duration presented with history of seizures, for which she was intubated and ventilated. Though Computerised tomogram brain was normal, she had weaning difficulty. Retrosternal goitre was considered as a cause of respiratory failure and hence thyroidectomy was done following which patient was successfully weaned off from the ventilator.