An Unusual Cause of Endotracheal Tube Obstruction

Endobronchial Obstruction from an Intubation Stylet Sheath

“…Shearing of the plastic sheath coating the metal stylet is an unusual cause of endobronchial obstruction in intubated babies and infants [1][2][3][4] . Such shearing is likely to occur if the stylet is bent to assist with intubation.…”

Acute airway obstruction by a sheared endotracheal intubation stylet sheath in a premature infant

“…Literature reviews found five case reports of acute airway obstruction by a sheared stylet sheath, four in premature infants and one in a 1-month-old term infant. [1][2][3][4][5] Recognizing this potential hazard, one manufacturer issued a recall. 14 It is unclear how the plastic sheath sheared off during the tracheal intubation procedure.…”

“…Literature reviews reveal that the majority of foreign bodies were derived from medical devices. [1][2][3][4][5][6][7][8] Despite the advance in videoendoscopic technology, removing foreign bodies from the airway of small infants remains a challenge, with the potential for causing significant morbidity or mortality. This paper reports a case of acute airway obstruction in a preterm infant caused by a sheared plastic sheath of an endotracheal intubation stylet used during tracheal intubation.…”

A close shave

“…This same stylet’s coating was discovered within a 4.5‐mm Mallinckrodt armoured tracheal tube [3]. In neonates and premature infants, partial [4] and total [5, 6] airway obstruction has occurred because of this shearing in small tracheal tubes (2.5–3.0 mm). The distal portion of stylet coating is stripped off into the tracheal tube and it has been suggested that sharp bends and kinks in stylets must be avoided [7].…”