Pilot Balloon Repair - An intraoperative challenge

Authors

DOI:

https://doi.org/10.25751/rspa.31578

Keywords:

Airway, Endotracheal tube, Extubation, Airway crisis

Abstract

An ASA IV, full-stomach 76-year-old patient diagnosed with a subdural haematoma was under TIVA for burr hole drainage. At the end of the procedure, while removing the surgical drapes, the neurosurgeon accidentally tears the pilot balloon. Air leakage became audibled and ventilation issues ensued.

A 20G intravenous catheter was inserted into the remaining pilot line, using the standard vein catheterization technique. After the needle was removed, a 10mL syringe was attached and the cuff was successfully refilled with air. The emergence was uneventful, and the patient was extubated at the end of the procedure.

There are several options to deal with a torn pilot balloon prior to a patient being ready for extubation. This rescue procedure prevented further airway manoeuvres maintaining a secure airway and contributing to the ventilatory and hemodynamic stability of this neurosurgical patient.

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References

Haas, C. F., Eakin, R. M., Konkle, M. A., & Blank, R. (2014). Endotracheal tubes: Old and new. Respiratory Care, 59(6), 933–955. https://doi.org/10.4187/respcare.02868

Owusu-Bediako, K., Turner, H., Syed, O., & Tobias, J. (2021). Options for intraoperative repair of a cut pilot balloon on the endotracheal tube. Medical Devices: Evidence and Research, 14, 265–269. https://doi.org/10.2147/MDER.S323982

Vemula, R. C., Prasad, B. C. M., Koyalmantham, V., & Kumar, K. (2020). Trephine Craniotomy versus Burr Hole Drainage for Chronic Subdural Hematoma—An Institutional Analysis of 156 Patients. Indian Journal of Neurotrauma, 17(02), 110–120. https://doi.org/10.1055/s-0040-1713461

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Published

2023-09-29

How to Cite

Cordeiro, N. A. (2023). Pilot Balloon Repair - An intraoperative challenge. Journal of the Portuguese Society of Anesthesiology, 32(3). https://doi.org/10.25751/rspa.31578

Issue

Vol. 32 No. 3 (2023): Revista da Sociedade Portuguesa de Anestesiologia

Section

Image in Anesthesiology

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Copyright (c) 2023 Nuno Almeida Cordeiro

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