Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Medline ® Abstract for Reference 13

of 'Assessment of respiratory distress in the mechanically ventilated patient'

Delayed obstruction of endotracheal tubes by aspirated foreign bodies: report of two cases.
Shlamovitz GZ, Halpern P
Ann Emerg Med. 2004;43(5):630.
We present 2 cases of endotracheal tube obstruction as a result of previously aspirated foreign bodies that moved from the bronchial tree into the endotracheal tube. The signs of endotracheal tube obstruction were demonstrated in both cases: (1) activation of the high-pressure alarm; (2) difficulty ventilating by using a bag-valve-mask device; (3) rapid decrease of end-tidal CO2; (4) oxygen desaturation that may have lagged behind the decrease of end-tidal CO2; and (5) the inability to advance a catheter down the endotracheal tube. The differential diagnosis of endotracheal tube obstruction is discussed, as are possible interventions to remove the obstruction and secure an open airway.
Department of Surgery, Lenox Hill Hospital, New York, NY, USA. gilshla@netvision.net.il