Awake Tracheal Intubation Using the ProVu™ Video Stylet in a Patient With Difficult Airway Due to Acromegaly

Key Takeaways for GI Nurses

• Patients with acromegaly present unique airway management challenges that require specialized equipment and techniques, including video-assisted intubation devices like the ProVu™ Video Stylet
• Awake intubation may be the preferred approach for acromegaly patients undergoing endoscopic procedures requiring general anesthesia, necessitating enhanced patient preparation and nursing support
• Understanding the anatomical changes associated with acromegaly—including enlarged tongue, thickened soft tissues, and altered airway geometry—is crucial for anticipating potential complications during sedation and recovery
• Close collaboration with anesthesia teams and familiarity with advanced airway management equipment becomes essential when caring for patients with known difficult airways in the endoscopy suite

Clinical Relevance

This case report highlights critical considerations for GI nurses managing patients with acromegaly in endoscopy units. Acromegaly, caused by excess growth hormone, leads to progressive enlargement of facial features, tongue, and soft tissues that can significantly complicate airway management. For endoscopy nurses, this translates to heightened awareness during pre-procedure assessments, particularly when identifying patients who may require modified anesthetic approaches or specialized equipment. The successful use of the ProVu™ Video Stylet demonstrates how newer airway technologies can improve outcomes for challenging cases that might otherwise require more invasive procedures or pose significant risks.

From an operational standpoint, this case underscores the importance of having advanced airway management tools readily available in endoscopy suites, especially those serving patients with complex medical conditions. Nurses should be familiar with video stylet technology and understand how it differs from traditional intubation techniques. The awake intubation approach requires enhanced patient communication skills and the ability to provide reassurance while maintaining procedural efficiency. Additionally, this case emphasizes the value of multidisciplinary planning, where endoscopy nurses play a vital role in coordinating care between gastroenterology and anesthesia teams to ensure optimal patient outcomes.

Professional development opportunities arise from understanding these complex cases, as they expand the scope of knowledge required for contemporary endoscopy nursing practice. Nurses working in units that frequently manage patients with endocrine disorders or difficult airways should consider pursuing additional education in airway assessment techniques and become proficient with video-assisted intubation equipment to better support their anesthesia colleagues and ensure patient safety.

Bottom Line

GI nurses must recognize that patients with acromegaly require specialized airway management considerations that may include awake intubation techniques and advanced video equipment like the ProVu™ Video Stylet. This case reinforces the critical importance of thorough pre-procedure assessment, interdisciplinary communication, and familiarity with specialized airway devices to ensure safe endoscopic care for patients with anatomically challenging airways, ultimately expanding the scope of knowledge required for modern endoscopy nursing practice.