Unusual case of difficult double-lumen endotracheal tube removal.
A reusable Robertshaw red rubber double-lumen endotracheal tube (DLT) was placed to facilitate lung isolation for thoracoscopy in a 49-year-old atopic patient. In spite of its smooth insertion, it was then not possible to remove the DLT. Direct laryngoscopy showed severe laryngeal edema. After 48 hours of medical treatment with steroids, the trachea was extubated. The laryngeal edema could have been the result of physical and chemical irritation by the reusable rubber DLT itself, or from the substances formed during repeated cleaning and sterilization of the DLT. Atopic patients who are prone to developing latex allergy are also more liable to develop severe reactions to chemical, mechanical, and physical irritation from reusable red rubber DLTs or from the chemical solution used for its cleaning and sterilization.
Yazbek-Karam
Vanda G
VG
Department of Anesthesiology, Rizk Hospital, Beirut, Lebanon.
Haswani
Roula W
RW
Karam
Hoda S
HS
Haddad
Walid M
WM
Youssef
Pierre S
PS
Hachem
Boutros F
BF
Atik
Fouad T
FT
Rassi
Simon J
SJ
Yammine
Joseph N
JN
Baraka
Anis S
AS
Aouad
Marie T
MT
D000768:Anesthesia, General; D017743:Equipment Reuse; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation; D007819:Laryngeal Edema / Q000150:complications / Q000209:etiology; D007828:Laryngoscopy; D020315:Latex Hypersensitivity / Q000150:complications*; D008175:Lung Neoplasms / Q000473:pathology; D008875:Middle Aged; D011229:Preanesthetic Medication; D013242:Sterilization; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed