Airway Injury and Haemorrhage Associated with the Frova Intubating Introducer

Abstract

Airway trauma is a recognised complication of tracheal intubation when using an intubating introducer. We report such a case in which a Frova™ intubating introducer (bougie) traumatised the intermediate bronchus, at the junction of the right middle and inferior lobar bronchi. This caused major tracheobronchial haemorrhage and hypoxia. The injury resulted in formation of a flap of tissue, which then obstructed the right middle and inferior bronchi with a ball-valve effect. We discuss the relevant literature and explore other contributory factors to this life-threatening complication.