Anesth Pain Med.  2017 Jan;12(1):52-55. 10.17085/apm.2017.12.1.52.

Perioperative management of tracheal injury following endotracheal intubation in a neonate: A case report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea. agnetask@naver.com
  • 2Department of Anesthesiology and Pain Medicine, Kangwon National University College of Medicine, Chuncheon, Korea.

Abstract

Tracheal injury in neonates is a rare but serious complication of endotracheal intubation. The morbidity and mortality are associated with early recognition and adequate management. Herein, we reported a case of perioperative management of neonatal tracheal injury following multiple attempts at endotracheal intubation caused by unanticipated difficulty.

Keyword

Complication; Endotracheal intubation; Neonate

MeSH Terms

Humans
Infant, Newborn*
Intubation, Intratracheal*
Mortality

Figure

  • Fig. 1 Chest PA shows resolved left-side pneumothorax after chest tube drainage (black arrow), pneumomediastineum (white arrows), and subcutaneous emphysema in both sides of the neck (gray arrows).

  • Fig. 2 Chest CT shows a displaced endotracheal tube to left anterolaterally.

  • Fig. 3 Chest CT shows pneumothorax (black arrow) and pneumo- mediastineum (white arrows).


Reference

1. Wei JL, Bond J. Management and prevention of endotracheal intubation injury in neonates. Curr Opin Otolaryngol Head Neck Surg. 2011; 19:474–7. DOI: 10.1097/MOO.0b013e32834c7b5c. PMID: 21986802.
2. Doherty KM, Tabaee A, Castillo M, Cherukupally SR. Neonatal tracheal rupture complicating endotracheal intubation: a case report and indications for conservative management. Int J Pediatr Otorhinolaryngol. 2005; 69:111–6. DOI: 10.1016/j.ijporl.2004.07.020. PMID: 15627458.
3. Méndez R, Pensado A, Tellado M, Somoza I, Liras J, Pais E, et al. Management of massive air leak following intubation injury in a very low birth weight infant. Br J Anaesth. 2002; 88:722–4. DOI: 10.1093/bja/88.5.722. PMID: 12067015.
4. Lagoo JY, Jose J, Kilpadi KA. Tracheal perforation in a neonate: A devastating complication following traumatic endotracheal intubation. Indian J Anaesth. 2013; 57:623–4. DOI: 10.4103/0019-5049.123343. PMID: 24403630. PMCID: PMC3883405.
5. Smith BA, Hopkinson RB. Tracheal rupture during anaesthesia. Anaesthesia. 1984; 39:894–8. DOI: 10.1111/j.1365-2044.1984.tb06578.x.
6. Regragui IA, Fagan AM, Natrajan KM. Tracheal rupture after tracheal intubation. Br J Anaesth. 1994; 72:705–6. DOI: 10.1093/bja/72.6.705. PMID: 8024923.
7. Krause MF, Hoehn T. Partial transsection of the neonatal trachea. Resuscitation. 1998; 38:43–6. DOI: 10.1016/S0300-9572(98)00069-0.
8. Schild JP, Wuilloud A, Kollberg H, Bossi E. Tracheal perforation as a complication of nasotracheal intubation in a neonate. J Pediatr. 1976; 88:631–2. DOI: 10.1016/S0022-3476(76)80024-8.
9. McLeod BJ, Sumner E. Neonatal tracheal perforation. A complication of tracheal intubation. Anaesthesia. 1986; 41:67–70. DOI: 10.1111/j.1365-2044.1986.tb12707.x. PMID: 3946778.
10. Yoon YC, Kim SJ, Jeong CW, Bae HB, Kwak SH. Tracheal laceration found after endotracheal general anesthesia : A case report. Anesth Pain Med. 2009; 4:83–6.
11. Sternfeld D, Wright S. Tracheal rupture and the creation of a false passage after emergency intubation. Ann Emerg Med. 2003; 42:88–92. DOI: 10.1067/mem.2003.278. PMID: 12827127.
12. Fernández Baena M, Fernández Jurado MI. Conservative management of tracheal rupture after intubation. Paediatr Anaesth. 1997; 7:325–7. DOI: 10.1046/j.1460-9592.1997.d01-80.x. PMID: 9243691.
13. Moschini V, Losappio S, Dabrowska D, Iorno V. Tracheal rupture after tracheal intubation: effectiveness of conservative treatment. Minerva Anestesiol. 2006; 72:1007–12. PMID: 17235268.
14. Pinsonneault C, Fortier J, Donati F. Tracheal resection and reconstruction. Can J Anaesth. 1999; 46:439–55. DOI: 10.1007/BF03012943. PMID: 10349923.
15. Weiss M, Engelhardt T. Proposal for the management of the unexpected difficult pediatric airway. Paediatr Anaesth. 2010; 20:454–64. DOI: 10.1111/j.1460-9592.2010.03284.x. PMID: 20337959.
Full Text Links
  • APM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr