Impossible Extubation due to Sutured Endotracheal Tube with the Bronchial Stump

Cho, Suk Tae; Lee, Jung Koo

Abstract

Using endotracheal intubation technique, anesthesiolgoists have enjoyed many facilities in dealing with patients for operations. Better maintenance of airway, easy controllability of ventilation, easy removal of bronchial secretion, and the possibility of positive pressure without infiation of the stomach etc. consist part of the merits of endotracheal intubation technique. This time the author et al. experienced an impossible extubation case in which the endotracheal tube was sutured with the right bronchial stump after right lower lobectomy of the lung. After initial operation for pulmonary tuberculosis (explorative thoracotomy followed by right upper and middle bilobectomy), continuous bleeding led the patient to receive second operation and after this, extubation was impossible at the recovery room. Guessing the poslsibility of the tube sutured with the bronchial stump, we checked the chest film and a formal reading was made by the radiologist. Under the impression of the sutured-tube, a third operation was performed. In the operation field three stitches with the black silk 1-0 was made at the tip of the tube during the reinforcement process around the stump clipping was found. After removal of the stitches, extubation was possible without resistance and the patient transferred to the intensive care unit. To get rid of such a severe complication, anesthesiologist can not be over careful to check the position of the tube during the operation about the bronchial stump site.