scholarly journals Endotracheal tube blockage during tracheo-oesophageal fistula surgery: A case report

2020 ◽  
Vol 9 (4) ◽  
pp. 224-227
Author(s):  
Anjali Poudel ◽  
Balkrishna Bhattarai ◽  
Nirman Prasad Gyawali ◽  
Rajesh Prasad Sah ◽  
Ashik Rajak
Keyword(s):  
Case Report ◽  
Endotracheal Tube ◽  
Positive Pressure Ventilation ◽  
Anaesthetic Management ◽  
Difficult Tracheal Intubation ◽  
Near Miss ◽  
Gastric Distension ◽  
Positive Pressure ◽  
Anesthetic Depth ◽  
Fistula Surgery

The multifarious anaesthetic challenges associated with tracheo-oesophageal fistula surgery are difficult tracheal intubation, continuous air leakage during positive pressure ventilation, gastric distension, sharing of the airway with surgeons, intraoperative desaturation due to surgical retractors and maintaining anesthetic depth. These challenges are managed properly only when pathophysiology of the fistula is well understood. In this case report we present an anaesthetic management with a near miss situation during repair of tracheo-oesophageal fistula in a neonate. Intraoperatively, the patient’s oxygen saturation decreased which did not improve despite correcting all possible reasons. Before the worst could have occurred, we identified endotracheal tube blockage as the cause and changing the tube on time saved the neonate.

Colonic interposition for oesophageal replacement surgery in a patient with left broncho-oesophageal fistula: anaesthetic management

2021 ◽  
Vol 14 (8) ◽  
pp. e243738
Author(s):  
Kavitha Girish ◽  
Ameya Pappu ◽  
Rashmi Ramachandran ◽  
Vimi Rewari
Keyword(s):  
Positive Pressure Ventilation ◽  
Perioperative Period ◽  
Anaesthetic Management ◽  
Double Lumen Tube ◽  
Positive Pressure ◽  
Colonic Interposition ◽  
Double Lumen ◽  
Lumen Tube ◽  
Replacement Surgery ◽  
Risk Of Aspiration

Management of an uncorrected broncho-oesophageal fistula in the perioperative period is a challenge for the anaesthesiologist. Positive pressure ventilation which is inevitable during surgery will lead to gastric insufflation and there is a high risk of aspiration of gastric contents. In this case report, we discuss how we used a double lumen tube to occlude a pericarinal broncho-oesophageal fistula. This method was quite effective as it obviated the need for isolating the lung as well as ensured smooth delivery of positive pressure ventilation during the surgery.

Injuries to the Neonatal Larynx from Long-Term Endotracheal Tube Intubation and Suggested Tube Modification for Prevention

1975 ◽  
Vol 84 (6) ◽  
pp. 764-770 ◽  
Author(s):  
Arthur S. Hengerer ◽  
Marshall Strome ◽  
Burton F. Jaffe
Keyword(s):  
Endotracheal Tube ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Long Term Effects ◽  
Posterior Commissure ◽  
Long Term Follow Up ◽  
Initial Injury ◽  
Cartilage Erosion

Since the early 1960's nasotracheal tubes have been used for neonates with primary respiratory diseases which necessitated positive pressure ventilation. This therapy may be required for extended periods of weeks to months meaning prolonged trauma to the neonatal larynx. The initial injury and long-term effects of the endotracheal tube in this age group have not been adequately investigated. The acute findings can be arytenoid and posterior commissure ulcerations and, in some cases, cartilage erosion. Long-term follow-up in these children to age 3.5 years showed a persistent arytenoid defect with chronic hoarseness. The consideration of a change in the structure of the endotracheal tube is suggested as a possible means of avoiding these injuries.

Face Masks Defended

PEDIATRICS ◽  
1976 ◽  
Vol 58 (4) ◽  
pp. 621-623
Author(s):  
Robert M. Shuman ◽  
Thomas K. Oliver
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Endotracheal Tube ◽  
Airway Pressure ◽  
Low Birthweight ◽  
Positive Pressure Ventilation ◽  
Positive Airway Pressure ◽  
Face Mask ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure

Pediatricians caring for the newborn are particularly aware of unexpected deleterious outcomes of well-intentioned therapy. Oxygen, chloramphenicol, sulfadiazine, and continuous positive airway pressure are examples. Elsewhere in this issue Pape et al.1 suggest that intermittent positive-pressure ventilation provided by a tight-fitting face mask in low-birthweight infants is yet another example. They observed a 30% incidence of significant intracerebellar hemorrhages in infants so treated (groups A and D). Such hemorrhages were seen in 10% of babies who were ventilated by an endotracheal tube rather than by mask (groups B and C), and were not seen in their 13 nonventilated babies (group E).

scholarly journals Hemopneumothorax in a COPD Patient Treated with Noninvasive Positive Pressure Ventilation: The Risk of Attendant Anticoagulation

2004 ◽  
Vol 11 (2) ◽  
pp. 159-162 ◽  
Author(s):  
R Raghavan ◽  
AK Ellis ◽  
W Wobeser ◽  
KB Sutherland ◽  
DE O'Donnell
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Positive Pressure Ventilation ◽  
Work Of Breathing ◽  
Noninvasive Positive Pressure Ventilation ◽  
Air Embolism ◽  
Gastric Distension ◽  
Positive Pressure ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Severe Copd

Noninvasive positive pressure ventilation (NIPPV) modalities have been proven to be effective in the setting of exacerbations of chronic obstructive pulmonary disease (COPD). Reported complications include pneumothorax, increased work of breathing, gastric distension and air embolism. This case demonstrates that patients with severe COPD on anticoagulant therapy are potentially at risk for the serious complication of combined lung barotrauma and hemorrhage while on acute NIPPV therapy. This is the first reported case of hemopneumothorax complicating NIPPV therapy.

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