Endotracheal Tube and Tracheobronchial Obstruction as Causes of Hypoventilation With High Inspiratory Pressures

Adjusting the endotracheal tube tip in management of tracheomalacia in an infant

“…Rarely, a malalignment of ETT endhole against the tracheal wall or the proximal edge of a stenosis also can presents the same picture. All these conditions are frequently unrecognized or incorrectly diagnosed by physical examination, chest radiograph or ETCO 2 detector [17][18][19]. Therefore, clinicians should maintain high suspicion in intubated patients with unexplained respiratory distress.…”

Answer

“…4 If the cuff is deflated and there is no change in the gas leak around the ETT, it suggests ETT obstruction. If the gas leak increases with deflation it suggests obstruction distal to the ETT.…”

“…Further, a gas leak with hyperinflation of the cuff suggests that the obstruction is distal to the ETT. 4 If the tube is kinked, a simple manual manipulation of the airway is needed.…”

Giant endotracheal thrombus: a rare cause of post-operative dyspnea

“…Once the endobronchial blood clot is diagnosed efforts for its removal should be done immediately. These efforts consist of primarily lavage, suctioning and forceps extraction by a flexible bronchoscope (6). If these procedures are not successful rigid bronchoscopy, Fogarty catheter usage or topical thrombolysis with streptokinase or urokinase may be applied (7)(8)(9).…”