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Pediatric Anesthesia
Anesthesia and Pain Medicine 2012;7(3):266-270.
Published online July 31, 2012.
Obstruction of the endotracheal tube due to cyanoacrylate leakage in a pediatric recurrent tracheoesophageal fistula patient: A case report
Hyun Joong Kim, Chae Seong Lim, Sangyoung So, Seok Hwa Yoon
Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea. seohwy@cnu.ac.kr
Abstract
A 6-year old female, who was operated on for tracheoesophageal fistula at the time of birth, was diagnosed with recurrent TEF, and it was decided to undergo endoscopic management, using cyanoacrylate under general anesthesia. After cuffing, the endotracheal tube was located at the level of the fistula, and endoscopic management was undertaken through the esophagus, using cyanoacrylate. The peak inspiratory pressure was shown to have increased from 18 to 28 cmH2O. We observed partial obstruction of the endotracheal tube end, and partial attachment of the cyanoacrylate to the tracheal wall. The patient's symptoms gradually improved, and no other particular finding was observed during the following two months. We suppose that the cyanoacrylate has been ventilated, and gradually excreted. In manipulation that may cause changes in the tube position, it is recommended to check ventilation via the fistula, and to recheck the tube position.
Key Words: Cyanoacrylate, Endotracheal tube, Tracheoesophageal fistula
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