A successful case of pediatric tracheal tube exchange utilizing gum-elastic bougie and videolaryngoscope.

Abstract

Here we report on our experiences with successful pediatric tracheal tube exchange utilizing the gum-elastic bougie (GEB; SmithMedical, USA) and videolaryngoscope (Pentax-AWS Airwayscope®; Hoya, Japan) with an infant-size Intlock in a ventilated child, whose condition was complicated by pneumonia and dilated cardiomyopathy. A 2-year-old female (height 77 cm; weight 8.8 kg) was transferred to our emergency department due to severe dyspnea and vital sign collapse. She was diagnosed with cardiac failure due to dilated cardiomyopathy associated with pneumonia. We performed emergent tracheal intubation with a tracheal tube with an internal diameter (ID) of 3.5 mm, and sedated her with midazolam and dexmedetomidine. Intensive care was continued with antibiotics and mechanical ventilation, and catecholamine support with dobutamine was added. Demands for secretion management and ventilator weaning dictated tracheal tube exchange with a larger size tube. To avoid cardiopulmonary collapse associated with tube exchange or prolonged hypoxia, we decided to perform tracheal tube exchange with