Partial airway obstruction caused by dissection of a reinforced endotracheal tube.

EDITOR: Ventilatory problems during surgery in the prone position may be a serious complication [1]. We report an incident where there was dissection of a reinforced endotracheal tube that led to its partial obstruction. This case shows an unexpected complication from reusing products intended for single use. A 62-yr-old female (weight 68 kg) who was scheduled for total laminectomy with posterior lumbar fusion for lumbar stenosis was intubated with a 7.0-mm reinforced endotracheal tube (Safetyflex; Mallinckrodt, Athlon, Ireland). Her lungs were ventilated with a mixture of sevoflurane 1.5 MAC (minimum alveolar concentration) in oxygen (35%) and nitrous oxide (65%). Her peak airway pressure (Ppeak) was 25 cmH2O and end-tidal CO2 (ETCO2) was 36 mmHg at the beginning of anaesthesia without wheezing. Ppeak increased to 30 cmH2O and ETCO2 to 40 mmHg in the prone position. Approximately 30 min after prone