Complete Endotracheal Tube Transection by Patient Bite: A Case Report and Algorithm for Fragment Identification and Extraction

Annette Ilg; Matthias Eikermann; Andrew J. Synn

doi:10.1213/XAA.0000000000001428

Complete Endotracheal Tube Transection by Patient Bite: A Case Report and Algorithm for Fragment Identification and Extraction

Annette Ilg, Matthias Eikermann, Andrew J. Synn

Research output: Contribution to journal › Article › peer-review

Abstract

We describe a case of a complete endotracheal tube (ETT) transection due to patient bite. The patient was intubated for postoperative pneumonia; during weaning of sedation, the patient was unable to tolerate pressure support ventilation (PSV) due to agitation. Adaptive support ventilation (ASV) improved patient comfort substantially. During a routine Spontaneous Breathing Trial (SBT) on PSV, the patient bit through the ETT, resulting in complete transection and an unsecured 20-cm airway fragment. Utilizing a multidisciplinary approach, we provided respiratory support and performed nasopharyngolaryngoscopy (NPL) to identify and extract the foreign body. An algorithm for management of ETT fragment extraction is provided.

Original language	English (US)
Pages (from-to)	e01428
Journal	A&A practice
Volume	15
Issue number	3
DOIs	https://doi.org/10.1213/XAA.0000000000001428
State	Published - Mar 19 2021
Externally published	Yes

ASJC Scopus subject areas

General Medicine

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10.1213/XAA.0000000000001428

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title = "Complete Endotracheal Tube Transection by Patient Bite: A Case Report and Algorithm for Fragment Identification and Extraction",

abstract = "We describe a case of a complete endotracheal tube (ETT) transection due to patient bite. The patient was intubated for postoperative pneumonia; during weaning of sedation, the patient was unable to tolerate pressure support ventilation (PSV) due to agitation. Adaptive support ventilation (ASV) improved patient comfort substantially. During a routine Spontaneous Breathing Trial (SBT) on PSV, the patient bit through the ETT, resulting in complete transection and an unsecured 20-cm airway fragment. Utilizing a multidisciplinary approach, we provided respiratory support and performed nasopharyngolaryngoscopy (NPL) to identify and extract the foreign body. An algorithm for management of ETT fragment extraction is provided.",

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AB - We describe a case of a complete endotracheal tube (ETT) transection due to patient bite. The patient was intubated for postoperative pneumonia; during weaning of sedation, the patient was unable to tolerate pressure support ventilation (PSV) due to agitation. Adaptive support ventilation (ASV) improved patient comfort substantially. During a routine Spontaneous Breathing Trial (SBT) on PSV, the patient bit through the ETT, resulting in complete transection and an unsecured 20-cm airway fragment. Utilizing a multidisciplinary approach, we provided respiratory support and performed nasopharyngolaryngoscopy (NPL) to identify and extract the foreign body. An algorithm for management of ETT fragment extraction is provided.

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Complete Endotracheal Tube Transection by Patient Bite: A Case Report and Algorithm for Fragment Identification and Extraction

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