Endotracheal tube blockage in tracheoesophageal fistula: A case report
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Keywords

Endotracheal tube
Neonate
Tracheo-oesophageal fistula

How to Cite

Poudel, A., Bhattarai, B., Gyawali, N. P. ., Sah, R. P. ., & Rajak, A. (2021). Endotracheal tube blockage in tracheoesophageal fistula: A case report. Journal of Kathmandu Medical College, 9(4), 224–227. Retrieved from https://jkmc.com.np/ojs3/index.php/journal/article/view/935

Abstract

The multiple anesthetic challenges associated with tracheoesophageal fistula surgery are difficult tracheal intubation, continuous air leakage during positive pressure ventilation, gastric distension, sharing of the airway with surgeons, intraoperative desaturation due to surgical retractors and maintaining anesthetic depth. These challenges are managed properly only when pathophysiology of the fistula is well understood. In this case report we present an anesthetic management with a near miss situation during repair of tracheoesophageal fistula. Intraoperatively, desaturation occurred which did not increase despite correcting all possible reasons. Before the worst could have occurred, we identified endotracheal tube blockage and changing the tube on time saved the neonate.

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References

Kulkarni K, Shewta KM, Kadakia S, Prasad S. Successful Management of Neonatal Tracheoesophageal Fistula with Epidural and General Anaesthesia. J Anesth Crit Care Open Access. 2017;7(4):00268. [DOI]

MD JH. Bronchoscopic findings and treatment in congenital tracheo?oesophageal fistula. Pediatr Anesth. 1992;2(4):297–303. [DOI]

Nail S, Dhumal P, JV P. Tracheo-esophageal Fistula with vactrel anomaly: an anesthetic challenge. J Drug Discovery Therapeutics. 2015 Oct;3(33):1-3.

Raksakietisak M, Vudhikamraksa S, Surachetpong S. Perioperative Desaturation: Incidence, Causes, Management and Outcome. J Med Assoc Thai. 2002 Sept;85(Suppl 3):S981-6. [PubMed]

Ehrenfeld JM, Funk LM, Van Schalkwyk J, Merry AF, Sandberg WS, Gawande A. The incidence of hypoxemia during surgery: Evidence from two institutions. Can J Anesth. 2010;57(10):888–97. [DOI | PubMed]

Cross CE, Rieben PA, Barron CI, Salisbury PF. Effects of arterial hypoxia on the heart and circulation: an integrative study. Am J Physiol. 1963;205(5):963–70. [DOI | PubMed]

Atzori P, Iacobelli BD, Bottero S, Spirydakis J, Laviani R, Trucchi A, et al. Preoperative tracheobronchoscopy in newborns with esophageal atresia: does it matter? J Pediatr Surg. 2006;41(6):1054–7. [DOI | PubMed]

Taneja B, Saxena KN. Endotracheal intubation in a neonate with esophageal atresia and trachea-esophageal fistula: pitfalls and techniques. J Neonatal Surg. 2014;3(2):18. [PubMed]