Shock Due to an Obstructed Endotracheal Tube

Endotracheal tube obstruction by a mucus plug causing a ball-valve effect is a rare but significant complication. The inability to pass a suction catheter through the endotracheal tube with high peak and plateau pressure differences are classical features of an endotracheal tube obstruction. A case...

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Autores principales:	Chua Stefanie Foong Ling, Chan Chi Ho, Thangavelautham Suhitharan
Formato:	article
Lenguaje:	EN
Publicado:	Sciendo 2021
Materias:	obstruction endotracheal tube mucus plug bronchoscopy ball-valve Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/688c3a8a8ee6410a9f3ef68bafe6f41e
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spelling	oai:doaj.org-article:688c3a8a8ee6410a9f3ef68bafe6f41e2021-12-05T14:11:08ZShock Due to an Obstructed Endotracheal Tube2393-181710.2478/jccm-2021-0027https://doaj.org/article/688c3a8a8ee6410a9f3ef68bafe6f41e2021-10-01T00:00:00Zhttps://doi.org/10.2478/jccm-2021-0027https://doaj.org/toc/2393-1817Endotracheal tube obstruction by a mucus plug causing a ball-valve effect is a rare but significant complication. The inability to pass a suction catheter through the endotracheal tube with high peak and plateau pressure differences are classical features of an endotracheal tube obstruction. A case is described of endotracheal tube obstruction from a mucus plug that compounded severe respiratory acidosis and hypotension in a patient who simultaneously had abdominal compartment syndrome. The mucus plug was not identified until a bronchoscopic assessment of the airway was performed. Due to the absence of classical signs, the delayed identification of the obstructing mucus plug exacerbated diagnostic confusion. It resulted in various treatments being trialed whilst the patient continued to deteriorate from the evasive offending culprit. We suggest that earlier and more routine use of bronchoscopy should be employed in an intensive care unit, especially as a definitive way to rule out endotracheal obstruction.Chua Stefanie Foong LingChan Chi HoThangavelautham SuhitharanSciendoarticleobstructionendotracheal tubemucus plugbronchoscopyball-valveMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENThe Journal of Critical Care Medicine, Vol 7, Iss 4, Pp 308-311 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	obstruction endotracheal tube mucus plug bronchoscopy ball-valve Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	obstruction endotracheal tube mucus plug bronchoscopy ball-valve Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Chua Stefanie Foong Ling Chan Chi Ho Thangavelautham Suhitharan Shock Due to an Obstructed Endotracheal Tube
description	Endotracheal tube obstruction by a mucus plug causing a ball-valve effect is a rare but significant complication. The inability to pass a suction catheter through the endotracheal tube with high peak and plateau pressure differences are classical features of an endotracheal tube obstruction. A case is described of endotracheal tube obstruction from a mucus plug that compounded severe respiratory acidosis and hypotension in a patient who simultaneously had abdominal compartment syndrome. The mucus plug was not identified until a bronchoscopic assessment of the airway was performed. Due to the absence of classical signs, the delayed identification of the obstructing mucus plug exacerbated diagnostic confusion. It resulted in various treatments being trialed whilst the patient continued to deteriorate from the evasive offending culprit. We suggest that earlier and more routine use of bronchoscopy should be employed in an intensive care unit, especially as a definitive way to rule out endotracheal obstruction.
format	article
author	Chua Stefanie Foong Ling Chan Chi Ho Thangavelautham Suhitharan
author_facet	Chua Stefanie Foong Ling Chan Chi Ho Thangavelautham Suhitharan
author_sort	Chua Stefanie Foong Ling
title	Shock Due to an Obstructed Endotracheal Tube
title_short	Shock Due to an Obstructed Endotracheal Tube
title_full	Shock Due to an Obstructed Endotracheal Tube
title_fullStr	Shock Due to an Obstructed Endotracheal Tube
title_full_unstemmed	Shock Due to an Obstructed Endotracheal Tube
title_sort	shock due to an obstructed endotracheal tube
publisher	Sciendo
publishDate	2021
url	https://doaj.org/article/688c3a8a8ee6410a9f3ef68bafe6f41e
work_keys_str_mv	AT chuastefaniefoongling shockduetoanobstructedendotrachealtube AT chanchiho shockduetoanobstructedendotrachealtube AT thangavelauthamsuhitharan shockduetoanobstructedendotrachealtube
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Shock Due to an Obstructed Endotracheal Tube

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