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Localized tracheomalacia as a complication of the Cole tracheal tube

C Brewis1, J P Pracy, D M Albert

  • 1Department of Paediatric Otolaryngology, Great Ormond Street Hospital for Children, London, UK.

Paediatric Anaesthesia
|December 22, 1999
PubMed

Insights

Prolonged use of the Cole tracheal tube in neonates can lead to tracheomalacia, a serious airway complication. This case highlights the risks associated with extended intubation using this device in infants.

Area of Science:

  • Pediatric critical care medicine
  • Neonatology
  • Otolaryngology

Background:

  • The Cole tracheal tube is commonly used for neonatal intubation.
  • Subglottic stenosis is a known complication of prolonged intubation with the Cole tube.

Observation:

  • A 4-month-old infant with multiple medical issues experienced repeated extubation failures.
  • The infant presented with severe inspiratory collapse in the upper trachea.
  • This collapse was attributed to prolonged intubation with a Cole tracheal tube.

Findings:

  • A case of tracheomalacia, or tracheal collapse, was identified as a complication.
  • The collapse was localized to the upper 1 cm of the trachea, likely due to the Cole tube's shoulder.
  • The infant's condition necessitated a tracheostomy to manage the airway collapse.

Implications:

  • This case suggests tracheomalacia is a potential complication of prolonged Cole tracheal tube use in neonates.
  • Careful consideration of intubation duration and device selection is crucial in high-risk infants.
  • Further research into the long-term effects and alternative devices may be warranted.

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