Reinforced endotracheal tube: A life threatening experience in intensive care unit

Wadhwa, Rachna; Dhakate, Gaurav; Chilkoti, Geetanjali T

doi:10.4103/1658-354x.115348

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…of this kind of ETT. This phenomenon has previously been described in some case reports where, after a patient had bitten the ETT, an increased peak pressure during ventilation and a significant desaturation were observed [16,17]. Care should be taken when using this type of ETT for long-term use during mechanical ventilation in the ICU, except for specific purposes, due to the increased ETT resistance after clamping.…”

Section: Discussionmentioning

confidence: 57%

Does endo-tracheal tube clamping prevent air leaks and maintain positive end-expiratory pressure during the switching of a ventilator in a patient in an intensive care unit? A bench study

et al. 2020

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ObjectivesWhen patients with acute respiratory distress syndrome are moved out of an intensive care unit, the ventilator often requires changing. This procedure suppresses positive end expiratory pressure and promotes lung derecruitment. Clamping the endotracheal tube may prevent this from occurring. Whether or not such clamping maintains positive end-expiratory pressure has never been investigated. We designed a bench study to explore this further. How the study was doneWe used the Elysee 350 ventilator in 'volume controlled' mode with a positive end-expiratory pressure of 15 cmH2O, connected to an endotracheal tube with an 8 mm internal diameter inserted into a lung model with 40 ml/cmH2O compliance and 10 cmH2O/L/s resistance. We measured airway pressure and flow between the distal end of the endotracheal tube and the lung model. We tested a plastic, a metal, and an Extra Corporeal Membrane Oxygenation clamp, each with an oral/nasal, a nasal, and a reinforced endotracheal tube. We performed an end-expiratory hold then clamped the endotracheal tube and disconnected the ventilator. We measured the change in airway pressure and volume for 30 s following the disconnection of the ventilator.

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Section: Discussionmentioning

confidence: 57%

Does endo-tracheal tube clamping prevent air leaks and maintain positive end-expiratory pressure during the switching of a ventilator in a patient in an intensive care unit? A bench study

et al. 2020

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“…12 Wired endotracheal tubes are not recommended in intensive care, but in oral surgeries there may be edema of the structures, which prevents or makes it difficult to change ROT at the end of the procedure. 13 In the case in question, the anesthetic team reported difficulties during oral intubation, but Journal of Mechanical Ventilation 2022 Volume 3, Issue 2 86 there was no edema in upper airway structures, a fact that would not prevent its exchange. The knowledge of the possible complications of ROT allows the early diagnosis of the problem.…”

Section: Discussionmentioning

confidence: 99%

Airway obstruction by a folding metal rod within a Reinforced Oral tracheal Tube: Case Report

Franck¹,

Sousa²,

Voltolini³

et al. 2022

JMV

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The Reinforced Orotracheal Tube (ROT) is an airway device for intubation that allows invasive ventilation during general anesthesia. The ROT differs from a Conventional Endotracheal Tube (CET) by the presence of a stainless-steel spiral, which strengthens the wall and hinders collapse. The ROT can be used when there is a risk of obstructing the flow of gases through compression or elbowing of the endotracheal tube, during orofacial surgical procedures, neurosurgery or in non-supine surgical positions under deep general anesthesia. The metallic spiral, which reinforces the lumen of this endotracheal tube, is subject to damage and deformities that can compromise the permeability of its lumen. The ROT should be used only during the surgical procedure under deep general anesthesia. If there is a need for the permanence of orotracheal intubation in the postoperative period of patients referred to the intensive care unit, the ROT should be replaced by the polyvinyl chloride CET, given the risk of damage to the ROT due to bites with fracture of the metal rod and obstruction by folding, as in this case, which will be reported below. The rarity of similar reports in the literature and the severity of obstruction of an endotracheal tube causing severe hypoxemic disorders, guided the objective of this case report, which aims to guide preventive and resolving measures, in addition to including to the list of diagnoses of causes of acute obstructions of an endotracheal tube. Keywords: Airway obstruction; Armoured tube; intubation: mechanical ventilation.

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“…A pesar de que en estudios anteriores se habían reportado obstrucciones de los TEE reforzados, este es el unico caso de estudio que haya reportado oclusión en una UCI. 1,3 Dichas obstrucciones podrían producirse a causa de secreción de moco, cuerpos extraños, mordidas al tubo o exposición al óxido nitroso. Dado que no se recomiendan estos tubos en ambientes de cuidados intensivos, de rutina se retiran al final del procedimiento y se sustituyen por tubos endotraqueales estándar (PVC) sobre un cambiador de tubos.…”

Section: Discussionunclassified

“…También se ha reportado su obstrucción posterior a la colocación del paciente en posición prona; sin embargo, nunca se ha observado en unidades de cuidado crítico. 3 En el presente estudio se informa un caso inusual en el cual colapsó un TET reforzado por causa de la mordida del paciente.…”

Section: Introductionunclassified

A rare case of kinked reinforced endotracheal tube in an intensive care unit

Nikandish

Amini

Tarkesh

et al. 2020

Colombian Journal of Anesthesiology

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Reinforced endotracheal tube: A life threatening experience in intensive care unit

Cited by 3 publications

References 3 publications

Does endo-tracheal tube clamping prevent air leaks and maintain positive end-expiratory pressure during the switching of a ventilator in a patient in an intensive care unit? A bench study

Does endo-tracheal tube clamping prevent air leaks and maintain positive end-expiratory pressure during the switching of a ventilator in a patient in an intensive care unit? A bench study

Airway obstruction by a folding metal rod within a Reinforced Oral tracheal Tube: Case Report

A rare case of kinked reinforced endotracheal tube in an intensive care unit

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