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Tracheostomy Tube Exchange Failure Under General Anesthesia: A Case Report and Retrospective Analysis
Yuki Kojima1, Ryozo Sendo2,3, Kazuya Hirabayashi1
1Department of Anesthesiology, Asahi General Hospital, Chiba, Japan.
Anesthesia Progress
|October 18, 2023
Summary
Tracheostomy tube exchange can be challenging. Factors like tracheal depth, S/H ratio, and body weight may increase the risk of failed airway placement during this procedure.
Area of Science:
- Anesthesiology
- Otolaryngology
- Surgical Airway Management
Background:
- Head and neck cancer surgery often requires airway management strategies, including tracheostomy.
- Replacing an oral endotracheal tube (ETT) with a tracheostomy tube is a common procedure post-surgery.
Observation:
- A patient undergoing tongue cancer surgery experienced two failed attempts to replace the ETT with a tracheostomy tube.
- Ventilation was compromised, leading to a significant drop in peripheral oxygen saturation (SpO2) to 70%.
Findings:
- A retrospective analysis of 54 tracheostomy cases identified tracheal depth, S/H ratio, and body weight as potential risk factors for failed tracheal tube placement or exchange.
- These factors may contribute to difficulties in securing the airway during tracheostomy tube exchange.
Implications:
- Understanding these risk factors can help anesthesiologists anticipate and mitigate potential complications during tracheostomy procedures.
- Improved patient safety during airway management in head and neck cancer surgery is a critical outcome.
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