Limits...
Identifying and Managing a Malpositioned Endotracheal Tube Bite Block in an Orotracheally Intubated Patient

View Article: PubMed Central - PubMed

ABSTRACT

The universal bite block is increasingly used in orotracheally intubated patients. Here, we report a case of pilot tube dysfunction caused by a malpositioned universal bite block in an orotracheally intubated patient. We summarize the key points on identifying and managing a malpositioned universal bite block from this case and literature review.

A 74-year-old woman was emergently intubated during an episode of hyperkalemia-related cardiac arrest. A universal bite block was used for fixing the endotracheal tube. After her condition stabilized, ventilator weaning was attempted; however, a positive cuff-leak test result was observed.

The cuff-leak test revealed a lack of elasticity of the pilot balloon, which was completely deflated after 2 mL of air was removed. Pilot tube dysfunction was highly suspected. The bite block was slightly pulled out, and 8 mL of air was aspirated from the pilot tube. The patient was successfully extubated without stridor and respiratory distress.

Our case highlighted that a malpositioned bite block may obstruct the pilot tube, causing unfavorable consequences. While fixing the bite block on an endotracheal tube, it is crucial to ensure that the takeoff point of the pilot tube is located within the C-notch of the bite block.

No MeSH data available.


Related in: MedlinePlus

(A) Design of the endotracheal tube and universal bite block. (B) The takeoff point of the pilot tube should be kept within the C-notch of the universal bite block.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4998396&req=5

Figure 1: (A) Design of the endotracheal tube and universal bite block. (B) The takeoff point of the pilot tube should be kept within the C-notch of the universal bite block.

Mentions: A 74-year-old woman with a history of breast cancer surgery and valvular heart disease presented to the hospital because of poor appetite, oliguria, and generalized edema. She was intubated with a 7.0-mm, cuffed endotracheal tube (Mallinckrodt/Covidien, Nakompathom, Thailand) in the emergency department because of hyperkalemia-related cardiac arrest. Spontaneous circulation returned after 6 minutes of cardiopulmonary resuscitation. A universal bite block (Pacific Hospital Supply Co., Ltd, Taiwan) was used for fixing the endotracheal tube (Figure 1). The patient was then admitted to the intensive care unit (ICU) for further treatment.


Identifying and Managing a Malpositioned Endotracheal Tube Bite Block in an Orotracheally Intubated Patient
(A) Design of the endotracheal tube and universal bite block. (B) The takeoff point of the pilot tube should be kept within the C-notch of the universal bite block.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998396&req=5

Figure 1: (A) Design of the endotracheal tube and universal bite block. (B) The takeoff point of the pilot tube should be kept within the C-notch of the universal bite block.
Mentions: A 74-year-old woman with a history of breast cancer surgery and valvular heart disease presented to the hospital because of poor appetite, oliguria, and generalized edema. She was intubated with a 7.0-mm, cuffed endotracheal tube (Mallinckrodt/Covidien, Nakompathom, Thailand) in the emergency department because of hyperkalemia-related cardiac arrest. Spontaneous circulation returned after 6 minutes of cardiopulmonary resuscitation. A universal bite block (Pacific Hospital Supply Co., Ltd, Taiwan) was used for fixing the endotracheal tube (Figure 1). The patient was then admitted to the intensive care unit (ICU) for further treatment.

View Article: PubMed Central - PubMed

ABSTRACT

The universal bite block is increasingly used in orotracheally intubated patients. Here, we report a case of pilot tube dysfunction caused by a malpositioned universal bite block in an orotracheally intubated patient. We summarize the key points on identifying and managing a malpositioned universal bite block from this case and literature review.

A 74-year-old woman was emergently intubated during an episode of hyperkalemia-related cardiac arrest. A universal bite block was used for fixing the endotracheal tube. After her condition stabilized, ventilator weaning was attempted; however, a positive cuff-leak test result was observed.

The cuff-leak test revealed a lack of elasticity of the pilot balloon, which was completely deflated after 2 mL of air was removed. Pilot tube dysfunction was highly suspected. The bite block was slightly pulled out, and 8 mL of air was aspirated from the pilot tube. The patient was successfully extubated without stridor and respiratory distress.

Our case highlighted that a malpositioned bite block may obstruct the pilot tube, causing unfavorable consequences. While fixing the bite block on an endotracheal tube, it is crucial to ensure that the takeoff point of the pilot tube is located within the C-notch of the bite block.

No MeSH data available.


Related in: MedlinePlus