Inability to ventilate while using a silicone-based endotracheal tube

Stephen J. Gleich; Wayne T. Nicholson; Travis M. Jacobs; Roger E. Hofer; Juraj Sprung

doi:10.1016/j.jclinane.2008.03.008

Inability to ventilate while using a silicone-based endotracheal tube

Stephen J. Gleich, Wayne T. Nicholson, Travis M. Jacobs, Roger E. Hofer, Juraj Sprung

Anesthesiology

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

4 Scopus citations

Abstract

We present a complication associated with herniation of a specially designed silicone-based endotracheal tube (ETT) cuff used for laryngeal nerve monitoring (electromyographic [EMG] ETT). Lung ventilation in our patient was initially unimpeded. However, 30 minutes after initiation of anesthesia with desflurane and nitrous oxide, there was a sudden inability to ventilate due to the herniation of the ETT cuff presumably caused by diffusion of nitrous oxide into the silicone-based cuff. In vitro testing has shown that the increase in intracuff pressure during ventilation with nitrous oxide in the silicone-based EMG ETT is much greater (approximately 50 mmHg) than that in the polyvinyl chloride-based ETT (approximately 10 mmHg) routinely used in our department.

Original language	English (US)
Pages (from-to)	389-392
Number of pages	4
Journal	Journal of Clinical Anesthesia
Volume	20
Issue number	5
DOIs	https://doi.org/10.1016/j.jclinane.2008.03.008
State	Published - Aug 2008

Keywords

Anesthesia
Cuff herniation
Endotracheal tube cuff
General
Nitrous oxide

ASJC Scopus subject areas

Anesthesiology and Pain Medicine

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10.1016/j.jclinane.2008.03.008

Cite this

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title = "Inability to ventilate while using a silicone-based endotracheal tube",

abstract = "We present a complication associated with herniation of a specially designed silicone-based endotracheal tube (ETT) cuff used for laryngeal nerve monitoring (electromyographic [EMG] ETT). Lung ventilation in our patient was initially unimpeded. However, 30 minutes after initiation of anesthesia with desflurane and nitrous oxide, there was a sudden inability to ventilate due to the herniation of the ETT cuff presumably caused by diffusion of nitrous oxide into the silicone-based cuff. In vitro testing has shown that the increase in intracuff pressure during ventilation with nitrous oxide in the silicone-based EMG ETT is much greater (approximately 50 mmHg) than that in the polyvinyl chloride-based ETT (approximately 10 mmHg) routinely used in our department.",

keywords = "Anesthesia, Cuff herniation, Endotracheal tube cuff, General, Nitrous oxide",

author = "Gleich, {Stephen J.} and Nicholson, {Wayne T.} and Jacobs, {Travis M.} and Hofer, {Roger E.} and Juraj Sprung",

note = "Funding Information: Financial support was provided by the Department of Anesthesiology, Mayo Clinic, Rochester, MN. ",

year = "2008",

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doi = "10.1016/j.jclinane.2008.03.008",

language = "English (US)",

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T1 - Inability to ventilate while using a silicone-based endotracheal tube

AU - Gleich, Stephen J.

AU - Nicholson, Wayne T.

AU - Jacobs, Travis M.

AU - Hofer, Roger E.

AU - Sprung, Juraj

N1 - Funding Information: Financial support was provided by the Department of Anesthesiology, Mayo Clinic, Rochester, MN.

PY - 2008/8

Y1 - 2008/8

N2 - We present a complication associated with herniation of a specially designed silicone-based endotracheal tube (ETT) cuff used for laryngeal nerve monitoring (electromyographic [EMG] ETT). Lung ventilation in our patient was initially unimpeded. However, 30 minutes after initiation of anesthesia with desflurane and nitrous oxide, there was a sudden inability to ventilate due to the herniation of the ETT cuff presumably caused by diffusion of nitrous oxide into the silicone-based cuff. In vitro testing has shown that the increase in intracuff pressure during ventilation with nitrous oxide in the silicone-based EMG ETT is much greater (approximately 50 mmHg) than that in the polyvinyl chloride-based ETT (approximately 10 mmHg) routinely used in our department.

AB - We present a complication associated with herniation of a specially designed silicone-based endotracheal tube (ETT) cuff used for laryngeal nerve monitoring (electromyographic [EMG] ETT). Lung ventilation in our patient was initially unimpeded. However, 30 minutes after initiation of anesthesia with desflurane and nitrous oxide, there was a sudden inability to ventilate due to the herniation of the ETT cuff presumably caused by diffusion of nitrous oxide into the silicone-based cuff. In vitro testing has shown that the increase in intracuff pressure during ventilation with nitrous oxide in the silicone-based EMG ETT is much greater (approximately 50 mmHg) than that in the polyvinyl chloride-based ETT (approximately 10 mmHg) routinely used in our department.

KW - Anesthesia

KW - Cuff herniation

KW - Endotracheal tube cuff

KW - General

KW - Nitrous oxide

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ER -

Inability to ventilate while using a silicone-based endotracheal tube

Abstract

Keywords

ASJC Scopus subject areas

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