Inadvertent strangulation of inflation line of the pilot balloon during submental endotracheal intubation: a rare complication

Singh, Neha; Karthick, Kumar Sabari

doi:10.1007/s10877-020-00508-9

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…To the best of our knowledge, ours study is the first to prove that using an intravenous catheter in the clinic allows the simultaneous repair of two artificial airway devices, ETT and LMA. Our proposed method has distinct advantages over the previously reported patching method [ 6 , 20 ].…”

Section: Discussionmentioning

confidence: 96%

Efficacy of using an intravenous catheter to repair damaged expansion lines of endotracheal tubes and laryngeal masks

Wang

et al. 2022

BMC Anesthesiol

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Background In perioperative care or intensive care units, the expansion lines of endotracheal tubes (ETTs) or laryngeal mask airways (LMAs) may be accidentally cut off during medical procedures. We designed a simple method for repairing damaged ETT and LMA expansion lines. Methods In this in vitro study, ETT (n = 20) or LMA (n = 20) models were each categorized into experimental (n = 10) and control (n = 10) groups. In the experimental groups, the expansion lines were cut in the middle, and a 22G intravenous catheter was inserted into the broken end of each expansion line. The time taken to repair the expansion lines was recorded in both experimental groups. The repaired expansion lines in both groups were tested for visible underwater air leakage with cuffs under high pressure (120 cm H2O). After 15 h, the cuff pressure and tensile strength of the expansion lines were measured. Results The overall time required to repair the expansion line was 27.8 ± 1.5 s in the ETT group and 20.4 ± 1.1 s in the LMA group. When the cuff pressure was increased to 120 cmH2O, no air leakage was observed in the experimental LMA and ETT groups. The mean difference in the cuff pressures of the control and experimental groups was insignificant for both, ETT (9.50 ± 1.29 vs. 9.50 ± 1.08 cmH2O, 95% CI = − 1.11 to 1.11 cmH2O, P = 1.00) and LMA (34.1 ± 1.10 cmH2O vs. 34.5 ± 0.97 cmH2O, 95% CI = − 0.57 to 1.37 cmH2O, P = 0.40) groups, The tensile strength and the force required to pull apart the expansion lines in the experimental groups were lower than those in the control groups for ETTs (3.32 ± 0.37 N vs. 35.03 ± 4.47 N, 95% CI = − 34.69 to − 28.72 N, P < 0.0001) and LMAs (36.55 ± 2.20 N vs. 26.18 ± 1.67 N, 95% CI = − 12.21 to − 8.53 N, P < 0.0001). Conclusion An intravenous catheter can be directly inserted into the damaged ETT or LMA expansion lines; it is a simple, rapid, and effective repair method.

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Section: Discussionmentioning

confidence: 96%

Efficacy of using an intravenous catheter to repair damaged expansion lines of endotracheal tubes and laryngeal masks

Wang

et al. 2022

BMC Anesthesiol

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“…The common causes of airbag tube rupture in perioperative anaesthesia or during ICU care are bites, tears, or accidental severing of the tube while providing medical care when the patient is unconscious during resuscitation. [5][6][7][8][9][10][11][12] If the treatment is not timely, oral secretions and gastric contents can enter the airway leading to aspiration pneumonia, which in severe cases can result in death. [13]It is reported that a broken in ation line can be clamped with a syringe air supply vessel clamp to provide adequate airbag pressure, [5] however, this prevents the airbag pressure for being measured.…”

Section: Discussionmentioning

confidence: 99%

A Simple Method To Repair A Supraglottic Airway Device

Wang

et al. 2021

Preprint

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Background: During the perioperative period or while in the intensive care unit, the inflation line is often cut accidentally during medical procedures or is damaged. As a result, it is not uncommon for a cuff leak to result in inadequate ventilation for the patient. The risk of using endotracheal tubes (ETTs) for secondary intubation is great, increasing the probability of respiratory tract infection and injury and even causing death in severe cases. The best method is to repair the damaged ETT to avoid secondary intubation and to ensure the safety of patients. Therefore, we recommend a practical and straightforward method to repair damage to the line or valve assembly of an endotracheal tube(ETT) and laryngeal mask airway (LMA).Methods: The distal end of a 22G vein (IV) catheter was inserted into the broken end of the inflation line. After insertion, the internal tube was withdrawn 1 mm to restore the inflation line. After 15 hours, the repaired ETT/LMA devices were tested for air leakage by measuring the pressure and load-bearing tension of the inflation line.Results: There was no difference in ETTs pressure between five intact ETTs and five repaired ETTs (Group A, ETT, mean difference = 0.2 cmH2O; 95% confidence interval 1.78 to 2.12 cmH2O; P = 0.82). When the cuff expanded to 120 cm H2O, there was no air leakage in the five ETTs after repair, and the tensile strength of the inflation line of the repaired ETTs in the experimental group was lower than that in the control group (each n = 5; mean difference = 33.3N; 95% confidence interval, 27.5 to 39.1N; P <0.001). There was no difference in LMAs pressure (Group B, LMAs, mean difference = 0.4 cmH2O; 95% confidence interval: -1.8 to −2.6 cmH2O; P = 0.67). When the cuff was expanded to 120 cmH2O, there was no air leakage from the five repaired LMAs. The tensile strength of the inflation line of the repaired LMAs in the experimental group was lower than that in the control group (n = 5; mean difference = −10; 95% confidence interval: −14 to −5.8 N; P = 0.001).Conclusion: When the ETT, LMA inflation line, or valve assembly is damaged or accidentally broken, an IV catheter can be directly inserted into the inflation line to quickly and effectively repair it. It is a safe and effective emergency remedial measure, which can be widely used in the clinic.

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Dificuldades da intubação submentoniana em pacientes com traumas faciais: Scoping Review

Cruz¹,

Monteiro²,

Silva³

et al. 2020

RSD

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A intubação submentoniana consiste em uma técnica de manutenção da via aérea que tem seu acesso cirúrgico situado na região submentual medial/paramedial, paralelamente à base da mandíbula. O seu principal objetivo é substituir a intubação nasotraqueal quando esta é contraindicada, surgindo como uma opção à traqueostomia, que seria o próximo passo nesses casos. Esse artigo é uma scoping review com o objetivo de descrever as evidências de forma a elucidar as dificuldades encontradas na intubação submentoniana no trauma facial. A estratégia de busca se deu nos bancos de dados SciELO, LILACS, PubMed, The Cochrane Library, Web of Science, SCOPUS, CINAHL e Academic Search Premier (via plataforma EBSCO), Biblioteca Digital de Teses e Dissertações USP, Busca Integrada USP e banco de teses CAPES, considerando elegíveis estudos primários, revisões, metanálises e/ou metassínteses, livros e guidelines, teses e dissertações, publicados em fontes indexadas ou na literatura cinzenta e nos idiomas português, inglês e espanhol. Na literatura revisada, foram encontrados 23 diferentes grupos de dificuldades relacionadas ao procedimento. Entre elas, destacam-se como as mais descritas os danos ao tubo endotraqueal e a dificuldade na passagem do tubo pela incisão submentoniana. Portanto, os estudos analisados demonstraram uma grande variedade de dificuldades relacionadas a vários aspectos intrinsecamente relacionados a realização do procedimento da intubação submentoniana.

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Inadvertent strangulation of inflation line of the pilot balloon during submental endotracheal intubation: a rare complication

Cited by 3 publications

References 9 publications

Efficacy of using an intravenous catheter to repair damaged expansion lines of endotracheal tubes and laryngeal masks

Efficacy of using an intravenous catheter to repair damaged expansion lines of endotracheal tubes and laryngeal masks

A Simple Method To Repair A Supraglottic Airway Device

Dificuldades da intubação submentoniana em pacientes com traumas faciais: Scoping Review

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