Unforeseen Esophageal Misplacement of Airway Exchange Catheter Leading to Gastric Perforation

Abstract

To the Editor:-One always needs to be careful about stating that anything is "new," and I wonder if I might suggest to Ueda et al. 1 that they were incautious in their claim in regard to the use of regular intermittent bolus administration of epidural local anesthetic. This technique was studied in Edinburgh, many years ago, in both open 2 and randomized double-blind 3 studies in gynecologic patients. I am delighted that others are now studying this method of administration, but priority in this regard belongs properly to

Brief review: Supplementing oxygen through an airway exchange catheter: efficacy, complications, and recommendations

“…In one case, oxygen insufflation through a misplaced esophageal AEC led to gastric rupture within one hour of initiating therapy. 15 In the other case, manual ventilation through an AEC caused a pneumothorax. 16 Conversely, no patients suffered barotrauma in the abovementioned three case series involving 76 adult 3,4 and 20 pediatric spontaneously breathing patients 5,6 in whom oxygen insufflation was used at flow rates of 1-8 LÁmin -1 .…”

Esophageal misplacement of a single-lumen tube after its exchange for a double-lumen tube despite the use of an airway-exchange catheter

“…Fetterman et al . [9] reported a case of gastric perforation secondary to inadvertent esophageal placement of an AEC. They recommended that an AEC be treated as an ETT, and its placement should never be assumed to be correct until objective findings support that conclusion.…”

Bronchial lumen is the safer route for an airway exchange catheter in double-lumen tube replacement: preventable complication in airway management for thoracic surgery

“…An airway exchange catheter (AEC) facilitates exchanging from a DLT to a SLT, or vice versa (1)(2)(3). However, various AECassociated complications have been revealed, including laryngeal trauma (4), tracheobronchial trauma (5,6), pneumothorax (4,(7)(8)(9), lung laceration (10), esophageal perforation (11), and dislodgement of endotracheal tube (4). We present an unusual case in which an AEC was broken during exchange of a DLT to a SLT.…”