Korean J Anesthesiol.  2008 Aug;55(2):221-225. 10.4097/kjae.2008.55.2.221.

Hemoptysis and obstruction of the endotracheal tube by blood clot in a pediatric patient: A case report

• Bae JY
• Woo CH
• Yang MS
• Mun SH
• Kwak IS
• Kim KM

• KMID: 2299207
• DOI: http://doi.org/10.4097/kjae.2008.55.2.221

Abstract

Hemoptysis leading to airway obstruction by blood clot is a serious and potentially lethal condition in pediatric patients because of the unpredictable course and technical difficulty of managing small airways. An 11-month-old male patient with a contact burn on his left foot was intubated uneventfully during induction for general anesthesia. After 15 minutes, we noted blood in his endotracheal tube along with high airway pressure and desaturation. Immediate suction was performed, and the oxygen saturation recovered, but the airway pressure and small exhaled tidal volume were unchanged. We had difficulty differentiating endotracheal tube obstruction from bronchial spasm at that time. We successfully managed the endotracheal obstruction by extubation with removal of the blood clot and reintubation after the diagnosis was made using fiberoptic bronchoscopy. We review the etiology and management of airway obstruction and hemoptysis in the operating room.

Keyword

airway obstruction; hemoptysis; intubation; pediatric anesthesia

MeSH Terms

Airway Obstruction
Anesthesia, General
Bronchial Spasm
Bronchoscopy
Burns
Foot
Hemoptysis
Humans
Infant
Intubation
Male
Operating Rooms
Oxygen
Suction
Tidal Volume
Oxygen