Inability to ventilate while using a silicone-based endotracheal tube.

Abstract

We present a complication associated with herniation of a specially designed silicone-based endotracheal tube (ETT) cuff used for laryngeal nerve monitoring (electromyographic [EMG] ETT). Lung ventilation in our patient was initially unimpeded. However, 30 minutes after initiation of anesthesia with desflurane and nitrous oxide, there was a sudden inability to ventilate due to the herniation of the ETT cuff presumably caused by diffusion of nitrous oxide into the silicone-based cuff.

In vitro testing has shown that the increase in intracuff pressure during ventilation with nitrous oxide in the silicone-based EMG ETT is much greater (approximately 50 mmHg) than that in the polyvinyl chloride-based ETT (approximately 10 mmHg) routinely used in our department.

Full Text

• DOI - Journal of Clinical Anesthesia (DOI)
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Subjects

• Anesthesia, Inhalation
• Electromyography
• Humans
• Intubation, Intratracheal
• Isoflurane
• Laryngeal Nerves
• Male
• Middle Aged
• Monitoring, Intraoperative
• Nitrous Oxide
• Pulmonary Ventilation
• Silicones

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Authors

• Stephen J Gleich
• Wayne T Nicholson
• Travis M Jacobs
• Roger E Hofer
• Juraj Sprung

Publication date

2008-09-01

Journal

Journal topics

• Anesthesiology

Language

Eng.

Copyright

Journal of Clinical Anesthesia

Department of Anesthesiology, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.

Release reference

J Clin Anesth. 2008 Aug;20(5):389-92

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