Wegener's Granulomatosis

 

 

Considerations

 

  • Potential difficult airway: laryngeal stenosis, subglottic stenosis, tracheal stenosis, friable bleeding tissue

  • Multisystem granulomatous disease:

    • CNS: cerebral aneurysms, peripheral neuropathy

    • Cardiovascular: cardiac valve destruction, conduction defects, myocardial ischemia

    • Pulmonary: sinusitis, pulmonary fibrosis, pulmonary hypertension, pneumonia, hemoptysis, & bronchial destruction

    • Renal: hematuria, renal failure

  • Possible contraindication to arterial line due to peripheral arteritis

  • Medications including immunosupressants

 

 

Goals & Conflicts

 

  • Careful airway management

  • Document neurologic deficits prior to regional techniques

  • May present with massive hemoptysis & require emergency lung isolation