Related Experiment Video

Updated: Jun 27, 2026

Murine Left Pulmonary Hilar Clamp Model of Lung Ischemia Reperfusion Injury
06:45

Murine Left Pulmonary Hilar Clamp Model of Lung Ischemia Reperfusion Injury

Published on: April 12, 2024

Ischemic subglottic damage following a short-time intubation

Marta João Silva1, José Aparício, Teresa Mota

  • 1Pediatric Intensive Care Unit, Hospital São João, Porto, Portugal. martajoaosilva@iol.pt

European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine
|December 17, 2008
PubMed

Insights

Overinflated endotracheal tube cuffs in children can cause ischemic subglottic damage. Accurate measurement of endotracheal tube size and cuff pressure is crucial to prevent airway trauma.

Area of Science:

  • Pediatric Intensive Care
  • Anesthesiology
  • Otolaryngology

Background:

  • Endotracheal intubation is a common procedure in pediatric intensive care.
  • Complications can arise from improper endotracheal tube management, including airway trauma.
  • Subglottic stenosis is a potential serious outcome of airway injury.

Observation:

  • A 6-year-old boy experienced head trauma and required intubation.
  • A 5.5-mm inner diameter cuffed endotracheal tube was overinflated with 16 ml of air, exceeding 120 cm H2O.
  • The endotracheal tube cuff pressure was reduced after 4 hours.

Findings:

  • The patient developed postextubation stridor and subglottic edema.
  • This indicates ischemic subglottic damage secondary to prolonged high cuff pressure.
  • The case highlights the risk of airway trauma from incorrect endotracheal tube size and cuff pressure.

Implications:

  • Accurate measurement of endotracheal tube size and intracuff pressure is essential.
  • Proper endotracheal tube management can prevent significant pediatric airway morbidity.
  • This case underscores the need for vigilance in pediatric intubation practices.

More Related Videos

The Rigid Tube as an Alternative in Controlling the Problematic Airway08:26

The Rigid Tube as an Alternative in Controlling the Problematic Airway

Published on: June 6, 2020

A Model of Self-limited Acute Lung Injury by Unilateral Intra-bronchial Acid Instillation07:40

A Model of Self-limited Acute Lung Injury by Unilateral Intra-bronchial Acid Instillation

Published on: August 30, 2019

Related Concept Videos

Endotracheal Tube Extubation01:24

Endotracheal Tube Extubation

Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals.
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway interventions are...
Endotracheal Intubation II: Nursing Management01:17

Endotracheal Intubation II: Nursing Management

Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
Endotracheal Intubation I: Procedure01:15

Endotracheal Intubation I: Procedure

Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
Transient Ischemic Attack l: Introduction01:26

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...