title: Removal of endotracheal tube obstruction with a secretion clearance device.
abstract: Accumulation of secretions may suddenly occlude an endotracheal tube (ETT), requiring immediate medical attention. The endOclear catheter (Endoclear LLC, Petoskey, Michigan) is a novel device designed to clear mucus and debris from an ETT and restore luminal patency. We present 3 subsequent cases of life-threatening partial ETT occlusions recorded over a period of 6 months at Massachusetts General Hospital. After conventional methods (standard tracheal suctioning and bronchoscopy) failed, the endOclear was used, with successful restoration of the airways in all 3 cases. The respiratory conditions rapidly improved, and all 3 patients tolerated the ETT-cleaning maneuver. These results show that such a device is safe and easy to use during an emergency airway situation for efficient and rapid removal of secretions from obstructed ETTs by respiratory therapists.
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine.
authors.forename: Cristina
authors.initials: C
authors.lastname: Mietto
authors.affiliation: Department of Respiratory Care.
authors.forename: Kevin
authors.initials: K
authors.lastname: Foley
authors.affiliation: Department of Respiratory Care.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Salerno
authors.affiliation: Department of Respiratory Care.
authors.forename: Jenna
authors.initials: J
authors.lastname: Oleksak
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pinciroli
authors.affiliation: Department of Surgery, Burn Service, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Goverman
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine lberra@partners.org.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Berra
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy*; D057785:Catheters / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000295:instrumentation
keywords: airway obstruction; airway resistance; artificial; biofilms; pneumonia; positive-pressure ventilation; respiration; respiratory failure; ventilator-associated