Esophageal Perforation Associated with Endotracheal Intubation

Johnson, Kent G.; Hood, David D.

doi:10.1097/00000542-198602000-00031

Cited by 37 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cervical emphysema results from the entry of air or gas into the soft tissue planes. Numerous aetiologies for this accumulation have been recorded such as maxillofacial trauma (1), dental surgical procedures (2,3), adenotonsillectomy (4–8), traumatic intubation (9,10), excessive positive airway pressure ventilation (7), ventilator malfunction (11), excessive manual ventilation (12) and spontaneous emphysema (13).…”

Section: Discussionmentioning

confidence: 99%

Cervical subcutaneous emphysema: an unusual complication of adenotonsillectomy

Miman

Özturan

Durmuş

et al. 2001

Pediatric Anesthesia

View full text Add to dashboard Cite

Removal of the tonsils and adenoid tissue because of recurrent infection and/or respiratory obstruction is one of the most commonly performed operations. A rare complication during this intervention is subcutaneous surgical emphysema. The awareness of anaesthesiologists and otolaryngological surgeons will protect the patient from serious consequences. We report our experience with this complication and provide a review of the literature.

show abstract

Section: Discussionmentioning

confidence: 99%

Cervical subcutaneous emphysema: an unusual complication of adenotonsillectomy

Miman

Özturan

Durmuş

et al. 2001

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…1 The unanticipated difficult laryngoscopic intubation places patients at increased risk of complications ranging from sore throat to serious airway trauma. 2,3 Moreover, in some cases the anesthesiologist may not be able to maintain a patent airway, leading to severe complications such as brain damage or death. 4 Since these risks may be avoided by securing the airway prior to the induction of general anesthesia by alternative methods of tracheal intubation (e.g., fibreoptic bronchoscopy), it would be useful to identify these patients preoperatively.…”

mentioning

confidence: 99%

Predicting difficult intubation: a multivariable analysis

Karkouti

Rose

Wigglesworth

2000

Can J Anesth/J Can Anesth

162

View full text Add to dashboard Cite

730CAN J ANESTH 2000 / 47: 8 / pp [730][731][732][733][734][735][736][737][738][739] Purpose: To develop a clinically useful and valid model for predicting difficult laryngoscopic tracheal intubation in patients with seemingly normal airways by adhering to the principles of multivariable model development.Methods: This was an observational study performed at a tertiary-care teaching hospital. Preoperatively, 444 randomly selected patients requiring tracheal intubation for elective surgery were assessed. In addition, 27 patients in whom tracheal intubation was difficult, but were not assessed preoperatively, were assessed postoperatively. One assessor, blinded to the intubation information, collected the predictor variables. A reliable definition for difficult intubation was used and all attempts were made to eliminate sources of bias. Multivariable modeling was performed using logistic regression and the model was validated using the bootstrapping technique.Results: Of the 461 patients included in the analysis, 38 were classified as difficult to intubate. Multivariable analysis identified three airway tests that were highly significant for predicting difficult tracheal intubation. These were: 1) "mouth opening", 2) "chin protrusion", and 3) "atlanto-occipital extension". Using these tests, a validated, highly reliable and predictive model is produced to determine the probability of difficult intubation for patients. At a selected probability cut-off value, the model is 86.8% sensitive and 96.0% specific. Conclusion:A simple and accurate multivariable model, consisting of three airway tests, is produced for predicting difficult laryngoscopic tracheal intubation. Additional studies will be required to determine the accuracy and feasibility of this model when applied to a large sample of new patients by multiple anesthesiologists.Objectif : Élaborer un modèle valide et utilisable en clinique pour prédire des difficultés d'intubation trachéale laryngoscopique chez des patients qui ont apparemment des voies aériennes normales. Utiliser, pour ce faire, les principes d'élaboration d'un modèle multivariable.Méthode : Il s'est agi d'une observation réalisée dans un hôpital d'enseignement de soins tertiaires. Avant l'opéra-tion, on a évalué 444 patients choisis au hasard qui avaient besoin d'intubation endotrachéale pendant une intervention planifiée. De plus, 27 patients chez qui l'intubation a été difficile n'ont été évalués qu'après l'intervention. Un assistant, qui ne connaissait pas les conditions d'intubation, a enregistré les variables de prédiction. Une défi-nition exacte de l'intubation difficile a été utilisée et on a tenté d'éliminer tout biais possible. Une modélisation à multivariables a été réalisée en utilisant une régression logistique et le modèle a été validé par la technique de l'amorce («bootstrapping»).Résultats : Des 461 patients inclus dans l'analyse, 38 ont été difficiles à intuber. L'analyse à multivariables a reconnu trois épreuves d'intubation comme hautement significatives pour prédire une intu...

show abstract

“…Each of these fi ndings is dependent on the time interval since the injury and the amount of positive-pressure mask ventilation used during airway management. Johnson and Hood [8] reported a case of esophageal perforation that occurred during intubation and was immediately suspected because facial and cervical subcutaneous emphysema developed during positive-pressure mask ventilation. Our patient had no obvious subcutaneous emphysema.…”

Section: Discussionmentioning

confidence: 99%

Esophageal tear in a patient undergoing stereotactic brain biopsy under general anesthesia

2009

View full text Add to dashboard Cite

Injuries of the esophagus with resultant mediastinitis have been reported following endotracheal intubation. Herein, we report a case of esophageal perforation that resulted from difficulty with intubation in a patient with a stereotactic head frame. A 52-year-old woman underwent a stereotactic brain biopsy of a left temporal tumor. After a stereotactic head frame was applied, intubation for anesthesia required three attempts. On postoperative day 2, she complained of worsening dysphagia and chest pain. A 4-mm tear in the right posterior cervical esophagus was discovered and repaired. Esophageal perforation may arise from limited neck extension imposed by a stereotactic head frame. Unexplained dysphagia postoperatively is the hallmark of this rare complication.

show abstract

Esophageal Perforation Associated with Endotracheal Intubation

Cited by 37 publications

References 0 publications

Cervical subcutaneous emphysema: an unusual complication of adenotonsillectomy

Cervical subcutaneous emphysema: an unusual complication of adenotonsillectomy

Predicting difficult intubation: a multivariable analysis

Esophageal tear in a patient undergoing stereotactic brain biopsy under general anesthesia

Contact Info

Product

Resources

About