Endotracheal tube complication during extubation following surgical repair of a traumatic tracheal laceration

Abstract

Difficult or impossible tracheal extubation has previously been reported in the veterinary literature as a result of endotracheal tube (ETT) faults or due to their entanglement with oesophagostomy tubes. Inadvertent transfixation of the ETT to the trachea during oral–maxillofacial surgery is a reported cause of extubation complications in the human literature. In this case, an incident of accidental ETT cuff transfixation to the trachea of a dog undergoing surgical repair of a traumatic tracheal laceration is reported. General anaesthesia for tracheal surgery requires special consideration of airway management to reduce complications. While precautions can be taken to avoid ETT placement within the surgical field, this cannot always be avoided and measures should be implemented for detection of transfixation. If tracheal extubation complications do arise, it is important to consider the differential causes and act quickly to resolve the problem and ensure minimal distress to the animal.

Complete tracheal obstruction during anaesthesia for ventral slot decompression surgery in a dog

“…2,4 Inadvertent fixation of the ET tube (preventing extubation of the trachea) has been reported following cervical surgery. 10 To the authors' knowledge, this is the first case of ventilatory obstruction in a dog resulting from the surgical retraction of tissues in a ventral slot procedure. Several other causes of tracheal and airway obstruction have been reported in anaesthetised dogs.…”

“…Aspiration pneumonia was another reported complication causing morbidity and mortality in several cases 2,4 . Inadvertent fixation of the ET tube (preventing extubation of the trachea) has been reported following cervical surgery 10 …”

Inadvertent endotracheal tube cuff rupture during unilateral arytenoid lateralisation for laryngeal paralysis in a dog

“…Several cases of difficult or impossible extubation are described in the veterinary literature. [8][9][10][11][12][13][14] Accidental suturing of the ETT cuff during tracheal rupture repair 8 and inability to deflate the cuff have been described in dogs. 9 Additionally, the formation of an annulus around the distal ETT cuff, [10][11][12] entrapment of the pilot balloon during oesophagostomy tube placement 13 and breakage of the ETT during extubation due to biofilm formation have been reported.…”

“…Several cases of difficult or impossible extubation are described in the veterinary literature 8–14 . Accidental suturing of the ETT cuff during tracheal rupture repair 8 and inability to deflate the cuff have been described in dogs 9 .…”

Manejo Anestésico de Paciente con Síndrome Respiratorio Braquiocefálico Sometido a Cirugía Correctiva: Estudio de Caso

“…Se debe preoxigenar de tres a cinco minutos en todos los pacientes, para aumentar el contenido, la saturación de oxígeno arterial y prolongar el tiempo antes de que ocurra la desaturación (Ambros et al, 2018). Algunos de estos pacientes pueden tener una tráquea hipoplásica y/o inflamación de los tejidos de las vías respiratorias (Clarke et al, 2011) la intubación puede ser más compleja y llevar más tiempo, por lo que maximizar su capacidad de oxígeno residual es aún más importante en pacientes braquiocefálicos (Miller et al, 2020).…”