• BMJ case reports · Jan 2015

    Case Reports

    Fatal endotracheal tube obstruction due to the ball valve effect.

    • Karen Jante Woittiez and Arend Jan Jacob Woittiez.
    • VieCuri Medical Centre, Venlo, The Netherlands.
    • BMJ Case Rep. 2015 Jan 23; 2015.

    AbstractIn patients suffering from pulmonary haemorrhage, or in patients who recently received a tracheostomy, acute occlusion of the endotracheal tube due to a blood clot is a rare, but well-known complication. Acute and complete occlusion of the tube is easily recognisable. There are various methods of removing the obstructive clot, such as using a bronchoscope with forceps, topical thrombolysis, saline lavage and suctioning. There are no guidelines concerning preventive routine bronchoscopic lavage. When there is a partial obstruction of the endotracheal tube, ventilation is possible, although high inspiratory pressures are necessary. If the clot functions as a ball valve ventil, raised intrathoracic pressure will cause right-sided heart failure or tension pneumothorax. It is important to recognise a partially obstructed tube in time and remove the obstruction. 2015 BMJ Publishing Group Ltd.

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