Tracheal necrosis following tracheal intubation in a dog

Alderson, Briony; Senior, J. M.; Dugdale, Alex

doi:10.1111/j.1748-5827.2006.00161.x

Cited by 35 publications

(29 citation statements)

References 16 publications

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“…Following tracheal endoscopy a 1.5 × 5 cm flap of necrotic material occluding the trachea on inspiration was removed which resolved the clinical emergency (Alderson et al . ). In man, stricture has been reported in 10–22% of cases after tracheotomy or tracheal intubation, but only 1–2% of patients display symptoms (Grillo et al .…”

Section: Discussionmentioning

confidence: 97%

“…Multiple changes in body position without disconnection of the endotracheal tube from the breathing system have been suggested to damage tracheal mucosa (Alderson et al . ); however, this animal was not moved during the surgical procedure and/or whilst attached to the breathing system. The animal was moved to and from surgery whilst intubated, which is standard procedure in our hospital.…”

Section: Discussionmentioning

confidence: 99%

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Tracheal necrosis as a fatal complication of endotracheal intubation

Wylie

Foote

Rasotto

et al. 2015

Equine Veterinary Education

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Summary This case report describes the death of a yearling Thoroughbred colt due to segmental severe necrotising tracheitis with stenosis of the tracheal lumen, 19 days after endotracheal intubation for elective endoscopic surgery. The stenosis of the trachea leading to asphyxiation was caused by an inflammatory process accompanied by massive accumulation of necrotic material, fibrinous inflammatory exudate, oedema and granulation tissue. The cause of this inflammation was likely to be a bacterial infection secondary to traumatic damage of the tracheal mucosa. Given the clinical history and location of the lesion, the endotracheal tube used for general anaesthesia was hypothesised to be responsible for this damage. Delayed tracheal necrosis as a fatal complication of endotracheal intubation has not previously been described in the horse and should be considered as a potential catastrophic consequence following relatively innocuous clinical signs.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Tracheal necrosis as a fatal complication of endotracheal intubation

Wylie

Foote

Rasotto

et al. 2015

Equine Veterinary Education

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“…The pressure exerted on the trachea by the cuff acts to reduce in size or completely occlude capillaries in the walls of the trachea leading to ischaemia of the tracheal mucosa or cartilage. 17 For this reason a cuff pressure of no greater than 30 cmH 2 O is considered acceptable. 18 The cuff pressure used in this study was measured to be 281.3 cmH 2 O.…”

Section: Discussionmentioning

confidence: 99%

A novel intubation technique for minimally invasive longitudinal studies of rat lungs using hyperpolarized ³He magnetic resonance imaging

et al. 2012

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Hyperpolarized noble gas (HNG) magnetic resonance imaging (MRI) has been shown to be useful for studying rodent models of lung disease. Image quality can be substantially degraded by signal loss from molecular oxygen entering the airway, requiring invasive surgery to ensure a good seal between the endotracheal (ET) tube and trachea. A modified Foley catheter having an inflatable cuff near the tip provides a novel approach for ensuring image quality for HNG MRI, thereby enabling longitudinal studies and reducing animal numbers. A Foley catheter was modified for rodent intubation and to minimize dead space. Three pairs of age-matched male Sprague Dawley rats 400 (30) g were used. Two pairs were intubated using the Foley and the third with an intravenous catheter. Leak rates were measured from pressure versus time curves within each animal. The pairs were euthanized immediately or six days postrecovery to assess the effects of the procedure on animal health, as reflected by histological examination. The Foley catheter resulted in minimal leak rates (20.20 (0.03) versus 20.16 (0.05) cmH 2 O/s), and were shown to be well below upper-limit leak rates of 20.5 and 20.7 cmH 2 O/s. Tracheal samples from rats in a separate Foley group (not mechanically ventilated) showed superficial damage six days postextubation (grade ¼ 0).3 He imaging performed using the Foley showed good image quality. Though some technical issues remain to be solved, a modified Foley catheter used as an ET tube offers the potential to enable longitudinal studies in rodents and reduce animal numbers.

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“…While the advantages of endotracheal intubation outweigh the disadvantages, several complications have been reported in both animals and humans. In veterinary medicine these include: tracheal rupture in cats (Mitchell et al ), necrosis of the tracheal mucosa (Alderson et al ), herniation of the cuff (Bergadano et al ) and formation of an annulus at the distal part of the cuff in dogs (Sanchis Mora & Seymour ) and tracheal strictures in rabbits (Grint et al ). The purpose of this report is to describe two occasions where silicone endotracheal tubes fractured into two pieces.…”

Section: Introductionmentioning

confidence: 99%

Breakage of two silicone endotracheal tubes during extubation

Barrio

Espadas

Hughes

2015

J of Small Animal Practice

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Silicone endotracheal tubes broke during tracheal extubation of two dogs after uneventful anaesthesia. The remaining pieces were removed via endoscopy, and both dogs recovered with no further problems. A third silicone endotracheal tube broke while checking for cracks prior to its use. Biofilm formation on the surface of the endotracheal tube is thought to be the main cause of the breakage. Destruction of the biofilm is difficult, therefore exhaustive cleaning with detergents followed by vigorous brushing is recommended to break the interaction between the silicone surface and the biofilm. It is suggested that careful attention is paid to how tubes are cleaned and dried (in a hanging position), and that they are checked carefully for cracks prior to each use.

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Tracheal necrosis following tracheal intubation in a dog

Cited by 35 publications

References 16 publications

Tracheal necrosis as a fatal complication of endotracheal intubation

Tracheal necrosis as a fatal complication of endotracheal intubation

A novel intubation technique for minimally invasive longitudinal studies of rat lungs using hyperpolarized ³He magnetic resonance imaging

Breakage of two silicone endotracheal tubes during extubation

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Tracheal necrosis following tracheal intubation in a dog

Cited by 35 publications

References 16 publications

Tracheal necrosis as a fatal complication of endotracheal intubation

Tracheal necrosis as a fatal complication of endotracheal intubation

A novel intubation technique for minimally invasive longitudinal studies of rat lungs using hyperpolarized 3He magnetic resonance imaging

Breakage of two silicone endotracheal tubes during extubation

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A novel intubation technique for minimally invasive longitudinal studies of rat lungs using hyperpolarized ³He magnetic resonance imaging