Anesth Pain Med.  2017 Oct;12(4):394-397. 10.17085/apm.2017.12.4.394.

Intraoperative airway obstruction caused by dissection of the internal wall of a reinforced endotracheal tube: A case report

• Cheong Y
• Hwang B
• Kim I
• Chang T
• Kang S
• Kim M

• KMID: 2405861
• DOI: http://doi.org/10.17085/apm.2017.12.4.394

Abstract

Endotracheal intubation is the gold standard for airway management in general anesthesia. However, airway patency is not guaranteed by keeping the endotracheal tube (ETT) in place. Sometimes, the ETT itself may become a cause of airway obstruction; there are some reports on airway obstruction related to reinforced tube malfunction. We report a rare case with an obstruction of reinforced endotracheal tubes caused by dissection of the internal wall. Recognition of the possibility of airway obstruction due to a rare cause and monitoring patients vigilantly during anesthesia is very important for patient safety.

Keyword

Airway obstruction; Dissection; Endotracheal tube

MeSH Terms

Airway Management
Airway Obstruction*
Anesthesia
Anesthesia, General
Humans
Intubation, Intratracheal
Patient Safety

Figure

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  Fig. 1 Recovery from obstructive pattern of loops after endotracheal tube replacement. (A) Right and downward shifting in pressure-volume loop and diminished expiratory flow in flow-volume loop (calibrated scale), which indicates an obstructive pattern compared to B. (B) Normalized loops after tube replacement with similar values before peak inspiratory pressure elevation.

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  Fig. 2 Fiberoptic bronchoscopic and cross-sectional view of the reinforced endotracheal tube (ETT). (A) Fiberoptic bronchoscopic view showing the ETT lumen that is obstructed by the bulging inner wall. (B) Photograph of the cross-sectioned ETT showing the dissected inner wall bulging into the lumen.

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