Intraoperative acute airway obstruction due to the damage of a reinforced endotracheal tube in thyroidectomy

A 55-year-old woman was scheduled for left thyroidectomy. Anesthesia was induced without problems and maintained without nitrous oxide. Sixteen minutes after the start of the procedure, airway pressures and endtidal carbon dioxide concentration increased suddenly. An attempt to pass a suction cathet...

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Bibliographic Details
Published inMasui. The Japanese journal of anesthesiology Vol. 63; no. 10; p. 1128
Main Authors Ida, Mitsuru, Kuzumoto, Naoya, Nakayama, Kana, Krimoto, Katsuhiro, Kamiya, Toru, Iwata, Masato, Shimomura, Toshiyuki
Format Journal Article
LanguageJapanese
Published Japan 01.10.2014
Subjects
Airway Obstruction - etiology
Anesthesia
Equipment Failure
Female
Humans
Intraoperative Complications - etiology
Intubation, Intratracheal - adverse effects
Intubation, Intratracheal - instrumentation
Middle Aged
Thyroidectomy
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Summary:A 55-year-old woman was scheduled for left thyroidectomy. Anesthesia was induced without problems and maintained without nitrous oxide. Sixteen minutes after the start of the procedure, airway pressures and endtidal carbon dioxide concentration increased suddenly. An attempt to pass a suction catheter down the endotracheal tube was unsuccessful. A protuberance was found in the reinforced endotracheal tube. After reintubation with a new reinforced endotracheal tube, ventilation was improved immediately. The rest of the procedure was done uneventfully. Similar phenomenon was reported in the reuse of endotracheal tube and the use of nitrous oxide. In our case, airway obstruction was caused by the pinhole that was created in a manufacturing process. We have to keep in mind that endotracheal tube itself may be out of order if other causes have been excluded.
ISSN:0021-4892