Airway fire during tracheostomy.
BACKGROUND
Twenty-five cases of airway fire during tracheostomy have been reported in the literature. The authors describe a case observed in their centre 3 years ago, discuss the causes and preventive management and propose guidelines for prevention of this complication.


METHODS
A 66-year-old woman was intubated and ventilated with 100% oxygen during general anaesthesia for tracheostomy. On opening the trachea by monopolar diathermy, the oxygen present in the endotracheal tube caught fire, inducing combustion of the tube spreading to the lower airways. This airway fire was responsible for severe acute respiratory failure and the formation of multiple laryngotracheal stenoses.


CONCLUSIONS
Combustion of the endotracheal tube due to ignition of anaesthetic gases induced by the heat generated by diathermy is responsible for airway fire. These various phenomena are discussed. Prevention is based on safety measures and coordination of surgical and anaesthetic teams.
Département de cancérologie cervico-faciale, institut de cancérologie Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France. Electronic address: philippe.gorphe@igr.fr.
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P
Gorphe
Département de cancérologie cervico-faciale, institut de cancérologie Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
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B
Sarfati
Département de cancérologie cervico-faciale, institut de cancérologie Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
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F
Janot
Service d'anesthésie, institut de cancérologie Gustave-Roussy, 94800 Villejuif, France.
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JL
Bourgain
Service d'anesthésie, institut de cancérologie Gustave-Roussy, 94800 Villejuif, France.
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C
Motamed
Service d'anesthésie, institut de cancérologie Gustave-Roussy, 94800 Villejuif, France.
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F
Blot
Département de cancérologie cervico-faciale, institut de cancérologie Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
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S
Temam
D000368:Aged; D000768:Anesthesia, General; D004564:Electrocoagulation; D005260:Female; D005390:Fires; D006801:Humans; D007431:Intraoperative Complications; D007829:Laryngostenosis / Q000209:etiology; D010100:Oxygen / Q000008:administration & dosage*; D012131:Respiratory Insufficiency / Q000209:etiology; D014135:Tracheal Stenosis / Q000209:etiology; D014139:Tracheostomy
D010100:Oxygen
Airway fire; Diathermy; Tracheostomy