A Leaking Endotracheal Tube in a Prone Patient

You are to anesthetize a 30-yr-old man (91 kg) who is donating his bone marrow to an unknown person. He is classified as an American Society of Anesthesiologists physical status 1 with a class 1 airway. The patient has had no previous anesthesia/surgery and his family history is negative for anesthesia-related complications. He takes no medication and has no drug allergy. An IV is placed in his left hand and midazolam 2 mg is given in the preoperative holding area with good effect. He is anesthetized in a routine manner and mask ventilation is uneventful. After the airway is secured with an endotracheal tube, the patient is turned prone. His head is turned to the side so that you can see both eyes. Everything is progressing as planned until 10 min before the end, when you notice that there is a progressive leak in the endotracheal tube (ETT) cuff. You are eventually unable to blow up the cuff. The patient’s vital signs remain stable, but the oxygen saturation has decreased from 100% to 96%. The peak pressure has fallen from 36 to 22 cm H2O


Endotracheal Tube Endotracheal Intubation Drug Allergy Routine Manner Mask Ventilation 
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    Vickery IM, Burton GW. Throat packs for surgery. Anaesthesia 1997;32:565-572.CrossRefGoogle Scholar

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© Springer Science+Business Media, LLC 2008

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