Endobronchial rupture from endotracheal reintubation with an endotracheal tube guide

Endotracheal tube guides are often used to facilitate endotracheal tube exchange in patients whose airways are difficult to intubate. The absence of reported complications with this technique suggests it is a safe technique; however, we report a case of endobronchial rupture associated with such a guide. Diagnosis and management of tracheobronchial tears and alternative approaches to difficult reintubation are described.