Abstract
A preterm with gestational age of 24 weeks was intubated at day of life 16. The intubation was done in a routine manner with the use of a stylet. It took a significant effort from the clinician to pull the stylet out after intubation. After intubation the respiratory status of the neonate deteriorated requiring significantly greater support. When ventilating and oxygenating the infant was getting progressively difficult, the decision was made to change the endotracheal tube (ETT). The cause for deterioration of respiratory status was then determined to be a sheared piece of plastic from the sheath of the stylet which was lodged in the lumen of the ETT. After removal of the plastic particle, the condition of the infant improved significantly.
Highlights
Equipment failure is one of the considerations when acute deterioration of respiratory status is encountered in a Neonatal Intensive Care Unit (NICU) setting
It is common for the endotracheal tube (ETT) to be blocked by secretions but we present a case where a sheared-off piece of plastic tube from the stylet during the process of intubation leads to the blockage of the lumen of the ETT
The usual technique of intubating in the Neonatal Intensive Care Unit (NICU) at this Center was to use a stylet inserted into the endotracheal tube (ETT) at the time of intubation
Summary
Equipment failure is one of the considerations when acute deterioration of respiratory status is encountered in a Neonatal Intensive Care Unit (NICU) setting. Blocked endotracheal tube (ETT) is a common reason for failure of ventilation or oxygenation. It is common for the ETT to be blocked by secretions but we present a case where a sheared-off piece of plastic tube from the stylet during the process of intubation leads to the blockage of the lumen of the ETT. To the best of our knowledge, this rare occurrence has been reported no more than four times in the past
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