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...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2021-10-01
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| Series: | The Journal of Critical Care Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.2478/jccm-2021-0027 |
| _version_ | 1797422434082619392 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-09T07:32:14Z |
| format | Article |
| id | doaj.art-688c3a8a8ee6410a9f3ef68bafe6f41e |
| institution | Directory Open Access Journal |
| issn | 2393-1817 |
| language | English |
| last_indexed | 2024-03-09T07:32:14Z |
| publishDate | 2021-10-01 |
| publisher | Sciendo |
| record_format | Article |
| series | The Journal of Critical Care Medicine |
| spelling | doaj.art-688c3a8a8ee6410a9f3ef68bafe6f41e2023-12-03T05:51:10ZengSciendoThe Journal of Critical Care Medicine2393-18172021-10-017430831110.2478/jccm-2021-0027Shock Due to an Obstructed Endotracheal TubeChua Stefanie Foong Ling0Chan Chi Ho1Thangavelautham Suhitharan2Singapore General Hospital, Singapore, SingaporeSingapore General Hospital, Singapore, SingaporeSingapore General Hospital, Singapore, SingaporeEndotracheal 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.https://doi.org/10.2478/jccm-2021-0027obstructionendotracheal tubemucus plugbronchoscopyball-valve |
| spellingShingle | Chua Stefanie Foong Ling Chan Chi Ho Thangavelautham Suhitharan Shock Due to an Obstructed Endotracheal Tube The Journal of Critical Care Medicine obstruction endotracheal tube mucus plug bronchoscopy ball-valve |
| title | 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_short | Shock Due to an Obstructed Endotracheal Tube |
| title_sort | shock due to an obstructed endotracheal tube |
| topic | obstruction endotracheal tube mucus plug bronchoscopy ball-valve |
| url | https://doi.org/10.2478/jccm-2021-0027 |
| work_keys_str_mv | AT chuastefaniefoongling shockduetoanobstructedendotrachealtube AT chanchiho shockduetoanobstructedendotrachealtube AT thangavelauthamsuhitharan shockduetoanobstructedendotrachealtube |