Korean J Crit Care Med.  2013 May;28(2):146-151. 10.4266/kjccm.2013.28.2.146.

Occurrence of Acquired Tracheoesophageal Fistula Due to Excess Endotracheal Tube Cuff Volumes: A Case Report

• Kim MS
• Koh EJ
• Choi HY

• KMID: 2227863
• DOI: http://doi.org/10.4266/kjccm.2013.28.2.146

Abstract

Endotracheal tube cuff volume and pressure require constant monitoring to prevent tracheal injury. Acquired tracheoesophageal fistula is common from complications of mechanical ventilation as a result of pressured necrosis of the tracheoesophageal wall by endotracheal tube cuff. It still represents a life-threatening condition, especially when the diagnosis is being delayed. We present our modest experience through an acquired TEF patient who had an excessively enlarged cuff diameter on chest radiogram in order to consider the potential of using radiological-measured cuff diameter as a simple technique for predicting tracheal damages. Although the cuff pressure was monitored with a manometer by the medical team, it was possible that the tube cuff was excessively enlarged. Proper procedures for preventing the tracheal damage by cuffs include the following: monitoring of endotracheal cuff pressure and volume, observation of cuff size on the chest radiogram, and being mindful and attentive for possibilities of misjudgements by manometer or medical teams.

Keyword

complications; intubation; radiography; trachea; tracheoesophageal fistula

MeSH Terms

Humans
Intubation
Necrosis
Respiration, Artificial
Thorax
Trachea
Tracheoesophageal Fistula