폐전절제술을 받아 기관이 오른쪽으로 편향되어 있는 환자에서 경동맥 내막절제술 중에 발생한 강화 기관내관의 부분폐쇄 : 증례 보고
Partial Obstruction of an Armored Endotracheal Tube during a Carotid Endarterectomy due to Tracheal Deviation in a Pnemonectomized Patient
배선준 ; 김기준 ; 박윤곤 ; 김건호 ; 김종훈
Korean Journal of Anesthesiology (대한마취과학회지), Vol.41(1) : 105~109, 2001
Korean Journal of Anesthesiology (대한마취과학회지)
Endotracheal tube obstruction during anesthesia can have many causes. Hyperinflation of the remaining lung after a pneumonectomy can severely displace the trachea, and attachment of an endotracheal tube tip to the wall of a deviated trachea may also cause severe airway obstruction. The right lung of the patient was removed 3 years ago due to lung cancer. Compensatory hyperinflation of the left lung and severe right-sided tracheal deviation was seen on a chest X-ray. An armored endotracheal tube without Murphy's eye was used. Two hours after beginning the operation, peak airway pressure and PETCO2 began to increase gradually. A wheezing-like sound was heard. Bronchospasm was suspected, but signs of a spasm were not relieved by medications. The signs completely disappeared after pulling the tube 2 cm proximal. The position of the tube should be confirmed by fiberoptic bronchoscopy or chest X-ray after intubation when the trachea is deviated.