title: Failure to detect an unusual obstruction in a reinforced endotracheal tube with fiberoptic examination.
abstract: Obstruction of an endotracheal tube (ETT) is a potentially life-threatening event. We report an unusual obstruction of a reinforced ETT. The valve-like obstruction was caused by a partial detachment of the inner coating from the embedded spiral of the ETT. It led to an increase in inspiratory airway pressure, failure to detect end-expiratory CO(2), and generated a wheezing sound in forced expiration. Fiberoptic inspection, which is a recommended procedure for a suspected ETT-obstruction, failed to identify this detachment. Exchanging the defective ETT immediately resolved the critical clinical situation. The detachment was most likely caused by re-autoclavation of the ETT, which was a specified single-use product.
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, University of Cologne, Cologne, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Paul
authors.forename: Michael
authors.initials: M
authors.lastname: Dueck
authors.forename: Sandra
authors.initials: S
authors.lastname: Kampe
authors.forename: Frank
authors.initials: F
authors.lastname: Petzke
mesh_terms: D000236:Adenoma / Q000601:surgery; D000768:Anesthesia, General; D004868:Equipment Failure; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery