Unexpected difficulty in ventilating the lungs after tracheal intubation -A case report-

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Respiratory Therapy

Background:

• Effective ventilation is crucial post-tracheal intubation.
• Endotracheal tube (ETT) malposition can compromise gas exchange.
• Insufficient tidal volume delivery poses significant clinical risks.

Purpose of the Study:

• To report a case of ventilation difficulty after tracheal intubation.
• To highlight the potential for ETT orifice abutment against the tracheal wall.
• To illustrate the successful use of a double-lumen ETT in resolving such a complication.

Main Methods:

• Case report of a patient experiencing ventilation issues post-intubation.
• Fiberoptic bronchoscopic examination to identify ETT placement.
• Intervention involving the use of a double-lumen endotracheal tube.

Main Results:

• Initial endotracheal tube placement resulted in insufficient tidal volume.
• Fiberoptic examination revealed partial abutment of the ETT orifice against the trachea.
• Successful ventilation was achieved after placing a double-lumen endotracheal tube.

Conclusions:

• Partial abutment of the ETT orifice against the tracheal wall is a potential cause of ventilation failure.
• Double-lumen endotracheal tubes can be effective in overcoming such obstructions.
• Awareness of ETT bevel-related obstruction is critical for safe airway management.