Pneumothorax Caused by Airway Extubation Catheter in a Difficult Intubation Case

In the expected cases of difficult intubation, awake fiberoptic nasotracheal intubation and tube-changing catheter are being used. These practices can be life-saving but can also induce some complications, as well. In this case report, a patient with a mouth opening of 0.2 mm due to retromolar mass underwent awake fiberoptic nasotracheal intubation for biopsy. A tube changer catheter was used on the extubation. Pneumothorax was observed after extubation. In this case, we present our experience with awake fiberoptic nasotracheal intubation, extubation performed with an airway exchange catheter in a patient who subsequently developed pneumothorax.

[1]  E. Yurt,et al.  Advanced techniques in extubation: Bailey maneuver, tube exchange catheter and staged extubation set. , 2018, Journal of clinical anesthesia.

[2]  K. El-Boghdadly,et al.  A prospective cohort study of awake fibreoptic intubation practice at a tertiary centre , 2017, Anaesthesia.

[3]  M. Hollmann,et al.  Massive Subcutaneous Emphysema and Bilateral Tension Pneumothoraces After Supplemental Oxygen Delivery via an Airway Exchange Catheter: A Case Report , 2017, A & A case reports.

[4]  R. Noppens,et al.  Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow. , 2017, Journal of Visualized Experiments.

[5]  Thomas T. Joseph,et al.  A Retrospective Study of Success, Failure, and Time Needed to Perform Awake Intubation , 2016, Anesthesiology.

[6]  T. Cook,et al.  Macroscopic Barotrauma Caused by Stiff and Soft-Tipped Airway Exchange Catheters: An In Vitro Case Series , 2015, Anesthesia and analgesia.

[7]  S. Kheterpal,et al.  Airway Exchange Failure and Complications with the Use of the Cook Airway Exchange Catheter®: A Single Center Cohort Study of 1177 Patients , 2013, Anesthesia and analgesia.

[8]  J. Fukushima,et al.  Bronchial injury and pneumothorax after reintubation using an airway exchange catheter. , 2013, Brazilian journal of anesthesiology.

[9]  K. Takabe,et al.  Pneumothorax, an underappreciated complication with an airway exchange catheter. , 2012, Journal of thoracic disease.

[10]  M. Chalhoub,et al.  Endotracheal tube exchangers: should we look for safer alternatives? , 2012, Heart & lung : the journal of critical care.

[11]  J. Law,et al.  Brief review: Supplementing oxygen through an airway exchange catheter: efficacy, complications, and recommendations , 2011, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[12]  C. Nunn,et al.  Bilateral tension pneumothoraces following jet ventilation via an airway exchange catheter , 2007, Journal of Anesthesia.

[13]  S. Tsai,et al.  Gastric rupture after awake fibreoptic intubation in a patient with laryngeal carcinoma. , 2005, British journal of anaesthesia.

[14]  T. Heidegger,et al.  Structure and process quality illustrated by fibreoptic intubation: analysis of 1612 cases * , 2003, Anaesthesia.

[15]  A. Baraka Tension pneumothorax complicating jet ventilation via a cook airway exchange catheter. , 1999, Anesthesiology.

[16]  J. Benumof Airway exchange catheters: simple concept, potentially great danger. , 1999, Anesthesiology.

[17]  T. Dougherty,et al.  Anesthetic Management of the Patient Undergoing Head and Neck Cancer Surgery , 1998, International anesthesiology clinics.

[18]  M. Bishop,et al.  Lung laceration after tracheal extubation over a plastic tube changer. , 1991, Anesthesia and analgesia.

[19]  N. Gravenstein,et al.  Endobronchial rupture from endotracheal reintubation with an endotracheal tube guide. , 1989, Journal of clinical anesthesia.