Tracheal rupture with disposable polyvinylchloride double-lumen endotracheal tubes

Hasan, Ali Mohammed; Low, Donald E.; Ganado, A.L.; Norton, Robert L.; Watson, Donald C.

doi:10.1016/1053-0770(92)90201-h

Cited by 33 publications

(17 citation statements)

References 24 publications

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“…Nitrous oxide lead to increased volume, and accidental overinflation can result from its diffusion in the cuff. Cuff pressures can be increased up to 90%, even during relatively short procedures [9]. Fourthly, risk of tracheal injury increased more when overinflated cuff moved in the trachea.…”

Section: Discussionmentioning

confidence: 99%

Tracheal rupture after endotracheal intubation - A report of three cases -

Lim

Kim

et al. 2012

Korean J Anesthesiol

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Tracheal rupture is a rare but serious complication that occurs after endotracheal intubation. It usually presents as a linear lesion in the membranous wall of the trachea, and is more prevalent in women and patients older than 50 years. The clinical manifestations of tracheal injury include subcutaneous emphysema and respiratory distress. We report the cases of three female patients of old age presenting tracheal rupture after endotracheal intubation. Two cases received surgical repair without complication and one recovered uneventfully after conservative management. We presume that the tracheal injuries were caused by over-inflation of cuff and sudden movement of the tube by positional change. Therefore, we recommend cuff pressure monitoring during general anesthesia and minimized movement of the head and neck at positional change.

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Section: Discussionmentioning

confidence: 99%

Tracheal rupture after endotracheal intubation - A report of three cases -

Lim

Kim

et al. 2012

Korean J Anesthesiol

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“…For the technological cause, the maintenance of intubation, unskilled anesthesiologists, improper usage of stylets, overinflation of cuffs, rupture of cuffs, no pressure reduction of cuffs during posture changes are included. Anatomic causes include congenital malformation of airway, tracheobronchial transformation due to the lymphatic gland or tumor, inflammatory lesions, chronic obstructive bronchial diseases [10]. This is frequent especially for females because it is easy for the bronchus to be ruptured when the depth and size of the tubes are not appropriate due to a smaller trachea in women who are relatively shorter compared to men.…”

Section: Discussionmentioning

confidence: 99%

Left mainstem bronchial rupture during one-lung ventilation with Robertshaw double lumen endobronchial tube -A case report-

Kim

Jun

Lee

et al. 2010

Korean J Anesthesiol

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Lung separation using a double-lumen endobronchial tube is necessary for video assisted thoracoscopy (VATs). Bronchial rupture after intubation with a double-lumen endobronchial tube has been rarely reported. We report a case of a 70-year-old man who had solitary pulmonary nodule in his right upper lobe. He was intubated with a left-sided Robertshaw double-lumen endobronchial tube. He underwent a VATs right upper lobectomy with the one-lung ventilation of left lung. During the operation, the rupture of the left mainstem bronchus was detected. Immediately, the thoracotomy was performed and the ruptured left mainstem bronchus was repaired with absorbable sutures (vicryl). Seven days later he had a bronchoscopy to examine the left mainstem bronchus. There was no evidence of the bleeding, leakage and inflammation. Subsequent course was uneventful. Tracheobronchial injuries related to the double-lumen endobronchial tube are discussed.

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“…Anatomic factors that may increase the risk of injury, such as congenital anomalies of the airways, large mediastinal collections of lymph nodes or neoplasms, inflammatory lesions, and chronic obstructive airway disease, were not present. 10 The presence of injury in the cartilaginous part rather than in the vulnerable posterior membranous part of the trachea also rules out the intubation factor. 2,4,5 The endotracheal tube cuffs are permeable to nitrous oxide, leading to increased volume and accidental overinflation of the cuff, which may result in a tear in the trachea.…”

Section: Discussionmentioning

confidence: 99%