Korean J Anesthesiol.  2001 Jul;41(1):105-109. 10.4097/kjae.2001.41.1.105.

Partial Obstruction of an Armored Endotracheal Tube during a Carotid Endarterectomy due to Tracheal Deviation in a Pnemonectomized Patient

• Bai SJ
• Kim KJ
• Kim JH
• Kim KH
• Park WK

• KMID: 2298997
• DOI: http://doi.org/10.4097/kjae.2001.41.1.105

Abstract

Endotracheal tube obstruction during anesthesia can have many causes. Hyperinflation of the remaining lung after a pneumonectomy can severely displace the trachea, and attachment of an endotracheal tube tip to the wall of a deviated trachea may also cause severe airway obstruction. The right lung of the patient was removed 3 years ago due to lung cancer. Compensatory hyperinflation of the left lung and severe right-sided tracheal deviation was seen on a chest X-ray. An armored endotracheal tube without Murphy's eye was used. Two hours after beginning the operation, peak airway pressure and PETCO2 began to increase gradually. A wheezing-like sound was heard. Bronchospasm was suspected, but signs of a spasm were not relieved by medications. The signs completely disappeared after pulling the tube 2 cm proximal. The position of the tube should be confirmed by fiberoptic bronchoscopy or chest X-ray after intubation when the trachea is deviated.

Keyword

Complications: airway; endotracheal tube obstruction; Equipment: tubes, endotracheal

MeSH Terms

Airway Obstruction
Anesthesia
Bronchial Spasm
Bronchoscopy
Endarterectomy, Carotid*
Humans
Intubation
Lung
Lung Neoplasms
Pneumonectomy
Spasm
Thorax
Trachea