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HOME > Acute Crit Care > Volume 28(2); 2013 > Article
Case Report Occurrence of Acquired Tracheoesophageal Fistula Due to Excess Endotracheal Tube Cuff Volumes: A Case Report
Myeong Soo Kim, Eun Jeong Koh, Ha Young Choi

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1Department of Neurosurgery, Dong Kang Medical Center, Ulsan, Korea.
2Department of Neurosurgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School/Hospital, Jeonju, Korea.

Endotracheal tube cuff volume and pressure require constant monitoring to prevent tracheal injury. Acquired tracheoesophageal fistula is common from complications of mechanical ventilation as a result of pressured necrosis of the tracheoesophageal wall by endotracheal tube cuff. It still represents a life-threatening condition, especially when the diagnosis is being delayed. We present our modest experience through an acquired TEF patient who had an excessively enlarged cuff diameter on chest radiogram in order to consider the potential of using radiological-measured cuff diameter as a simple technique for predicting tracheal damages. Although the cuff pressure was monitored with a manometer by the medical team, it was possible that the tube cuff was excessively enlarged. Proper procedures for preventing the tracheal damage by cuffs include the following: monitoring of endotracheal cuff pressure and volume, observation of cuff size on the chest radiogram, and being mindful and attentive for possibilities of misjudgements by manometer or medical teams.

ACC : Acute and Critical Care