Tracheal rupture during anasthesia

Tracheal rupture after tracheal intubation

“…Although conservative treatment has been reported to be successful [1,2], because of the technical ease of the procedure and the immediate cure it provides with early mobilization, a surgical approach was selected for this patient after the pathology was ascertained at bronchoscopy. Repair would have been more strongly indicated had the patient been bronchitic with a chronic cough or if the sputum had been infected.…”

“…We know of 16 tracheal ruptures reported with intubation [1,2,[4][5][6][7][8]. When reviewed, only one was related definitely to cuff over-distension, in which pressurized oxygen was inadvertently connected to the cuff [8].…”

“…When reviewed, only one was related definitely to cuff over-distension, in which pressurized oxygen was inadvertently connected to the cuff [8]. In one patient, in which the tube was a red rubber Magill with a cuff known to eccentrically inflate posteriorly, there was, in addition, nearby dissection of the oesophagus and either or both of these causes may have been responsible for the tear [2]. In the other 14 patients, the mechanism was speculative.…”

“…The finding of a clean, sharp-edged tear at exploration excluded the blunt end of the tracheal tube as a cause and there was no obvious pathological abnormality of the trachea as a predisposing factor. The cuff may have been overinflated [2,8] or there may have been a sudden increase in intrabronchial pressure. Rupture from an over-distended cuff seems unlikely in this patient because of the position of the tear.…”

Differential lung ventilation and emergency hyperbaric oxygenation for repair of a tracheal tear

“…Rupture of the tracheobronchial tree can be due to overdistension of a tube cuff, 4 elevated intrathoracic pressure (chest trauma, closed chest compression during cardiopulmonary resuscitation, coughing), traumatic intubation, [5][6][7][8] or inherent weakness of the membraneous trachea. 9 The interval between rupture and the occurrence of symptoms ranges between 20 min and five days.…”