Case Reports in Clinical Medicine

Volume 2, Issue 2 (May 2013)

ISSN Print: 2325-7075   ISSN Online: 2325-7083

Google-based Impact Factor: 0.22  Citations  

Endotracheal tube exchange and pneumothorax: A case report

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DOI: 10.4236/crcm.2013.22050    4,938 Downloads   7,521 Views  Citations


Endotracheal intubation and extubation in intensive care unit (ICU) patients are difficult. Extubation will be more worrisome if patient has difficult intubation, sleep apnea, surgical procedure involving airway or surrounding structures. In such extubation airway exchange catheters (AEC) are used, as they are simple to use and able to provide oxygen to the patient. Rarely AEC use can cause potential life threatening complications. We report a case of pneumothorax following use of AEC in post-thyroidectomy patient. Case: A 32 years old male patient was admitted to our ICU, with difficult intubation after thyroidectomy. He was a known case of obtructive sleep apnea, hypertension and large goiter. In ICU for proper visualization of vocal cords and resecuring the airway, AEC was used, but patient had hypoxia with bradycardia. He was recovered with Ambu bag ventilation and required brief cardiopulmonary resuscitation. Post resuscitation he had left impending tension pneumothorax and lung laceration requiring chest drain, which was removed after tracheostomy and weaned from the ventilator. After 9 days supra glottic edema subsided and vocal cords were moving; His trachea was decanulated and he was discharged home. Conclusion: Rarely AEC use can cause life threatening injuries. Pneumothorax following the use of AEC is not always due to tracheobronchial injury; it can also occur as a result of alveolar injury.

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Shaikh, N. , Mahmood, K. , Wafa, A. and Kokash, O. (2013) Endotracheal tube exchange and pneumothorax: A case report. Case Reports in Clinical Medicine, 2, 183-185. doi: 10.4236/crcm.2013.22050.

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