Complete Endotracheal Tube Obstruc tion with Mucus during Anesthesia in a Child with Upper Respiratory Tract Infection : A case report

Han, Jongin; Kim, Chihyo; Lee, Sang Hyun; Burm, Jinsik

Case Report

Pediatric Anesthesia

Anesthesia and Pain Medicine 2007;2(2):82-84.
Published online April 30, 2007.

Complete Endotracheal Tube Obstruc tion with Mucus during Anesthesia in a Child with Upper Respiratory Tract Infection : A case report

Jongin Han, Chihyo Kim, Sang Hyun Lee, Jinsik Burm

¹Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea. hanji@ewha.ac.kr
²Department of Plastic Surgery, School of Medicine, Ewha Womans University, Seoul, Korea.

Abstract

We report here on a case of obstruction of a reinforced endotracheal tube (4.5 mm) with purulent bronchial secretions during performance of myringotomy and a pharyngeal flap operation under general anesthesia. This 4 year-old child, who had had a history of upper respiratory tract infection (URI), had been referred to a pediatrician before surgery and the baby was deemed to be well without any URI symptoms. But failure to achieve ventilation along with high end-tidal carbon dioxide tension and the inability to pass the catheter tip through the endotracheal tube were noticed 30 minute after the induction of anesthesia. We exchanged the tube for a 4.5 mm RAE tube and we found the reinforced tube was completely occluded by purulent secretions. After exchange of the tube, the patient's ventilation was improved immediately, but further surgical procedures were canceled by the plastic surgeon.

Key Words: airway, obstruction, pediatrics, tracheal, intubation, upper, respiratory