Report of a case of disorder in patient extubation due to improper fixing of the endotracheal tube

Document Type : Case Report

Authors
Fatemeh Eftekharian 1
Mohammad Sadegh Sanie Jahromi 2
Reza Sahraei 2
1 Assistant Professor, Department of Internal Medicine, Jahrom University of medical sciences, Jahrom, Iran.
2 Associated Professor, Department of Anesthesiology, Jahrom University of medical sciences, Jahrom, Iran.
10.22034/pjms.2023.708649
Abstract
Introduction: Difficult tracheal extubation is defined as unsuccessful or incomplete attempts at targeted removal of
an endotracheal tube (ETT). Difficult extubation is a rare and dangerous complication after surgery or in the intensive care unit. The present study has reported a case of disorder in patient extubation following inappropriate fixation of the endotracheal tube.
Case Personation: The patient is a 42-year-old man who underwent laminectomy surgery due to lumbar disc problems.
There was no specific disease in the previous history of the patient. The patient was intubated with a size 8 spring tracheal tube and the tube cuff was filled with air according to the standard. The surgery was performed in the prone position. After the end of the operation, the patient turned back to the supine position and the process of waking up the patient began. After reversing the effect of relaxants by atropine and neostigmine at the appropriate time, the tube was removed. The cuff of the tube was emptied with a 10 cc syringe, but the tube could not be removed. The anesthesiologist tried to remove the spring tube several times, but it was not possible to extubate the patient. At first, it was assumed
that the tube would break and the metal spring would come out and the spring would get stuck in the trachea. Finally, with double force, this tube was removed while its cuff was full of air, and after investigation, the reason was that the air drain tube was folded by the glue that was used to fix the tube on the patient's face.
Conclusion: Based on the results of the present study, improper fixation in patients undergoing general anesthesia
can increase the risk of difficult extubation by disrupting the process of emptying the tracheal tube cuff.
Keywords
Extubation
Tracheal Tube
Tracheal tube Cuff
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