We report here on a case of obstruction of a reinforced endotracheal tube (4.5 mm) with purulent bronchial secretions during performance of myringotomy and a pharyngeal flap operation under general anesthesia. This 4 year-old child, who had had a history of upper respiratory tract infection (URI), had been referred to a pediatrician before surgery and the baby was deemed to be well without any URI symptoms. But failure to achieve ventilation along with high end-tidal carbon dioxide tension and the inability to pass the catheter tip through the endotracheal tube were noticed 30 minute after the induction of anesthesia. We exchanged the tube for a 4.5 mm RAE tube and we found the reinforced tube was completely occluded by purulent secretions. After exchange of the tube, the patient's ventilation was improved immediately, but further surgical procedures were canceled by the plastic surgeon.
Anesthesia* ; Anesthesia, General ; Carbon Dioxide ; Catheters ; Child* ; Child, Preschool ; Humans ; Intubation ; Mucus* ; Pediatrics ; Respiratory System* ; Respiratory Tract Infections* ; Ventilation