title: [Dissection of the wired endotracheal tube's lumen during general anesthesia: a case report].
abstract: OBJECTIVE
  The aim of this study is to report a case of a clinically significant obstruction during mechanical ventilation caused by the dissection of the wired endotracheal tube's lumen during general anesthesia in a pediatric patient.
  
  
  METHODS
  A12-years old patient undergoing general anesthesia for open appendectomy was intubated with a wired endotracheal tube and difficult removal of the guide. After starting the mechanical ventilation, there was increased expiratory fraction of CO2and need for increased inspiratory pressure. Chance of complications with higher incidences were raised and treated unsuccessfully. Finally, during patient reintubation, the dissection of the endotracheal tube lumen was observed, and ventilation was restored to normal.
  
  
  CONCLUSIONS
  Anesthesia involves numerous possible complications. Suspicion and constant vigilance are essential for early diagnosis and treatment of any threat to the individual integrity. This case is relevant for emphasizing a possible very rare complication related to airway, which can quickly cause hypoxia and irreversible damage. Thus, this case contributes to the detection of this complication more frequently.
authors.affiliation: Centro de Ensino e Treinamento do Hospital de Base do Distrito Federal, Brasília, DF, Brasil. Electronic address: fabriciotmendonca@hotmail.com.
authors.forename: Fabricio Tavares
authors.initials: FT
authors.lastname: Mendonça
authors.affiliation: Centro de Ensino e Treinamento do Hospital de Base do Distrito Federal, Brasília, DF, Brasil.
authors.forename: Leonardo Damasceno
authors.initials: LD
authors.lastname: Martins
authors.affiliation: Centro de Ensino e Treinamento do Hospital de Base do Distrito Federal, Brasília, DF, Brasil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Gazzi
authors.affiliation: Centro de Ensino e Treinamento do Hospital de Base do Distrito Federal, Brasília, DF, Brasil.
authors.forename: Jose Tadeu Dos Santos
authors.initials: JTDS
authors.lastname: Palmieri
mesh_terms: D000768:Anesthesia, General / Q000295:instrumentation*; D002648:Child; D004868:Equipment Failure; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male
keywords: Airway obstruction; Complication of intubation; Complicação na intubação; Obstruction in ventilation; Obstrução de via aérea; Obstrução na ventilação