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Letters |

Endotracheal Tube Cuff Displacement

Jose E. Coppen, MD
JAMA. 1967;200(5):420. doi:10.1001/jama.1967.03120180108030.
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ABSTRACT

To the Editor:—  A 58-year-old female patient, with a history of pulmonary emphysema, chronic bronchitis, arteriosclerosis, angina pectoris, and compensated congestive heart-failure, was scheduled for "pinning of the humerus," for nonunion of a left humerus fracture.Induction was carried out with sodium thiopental, followed by a high flow of nitrous oxide and oxygen, supplemented with methoxyflurane. Succinlycholine was given intravenously, and orotracheal intubation was performed with an orotracheal tube (36 Collins) and replaceable cuff.A few minutes after intubation, a progressively increasing respiratory obstruction developed, both inspiratory and expiratory. A thorough investigation of the airway and the anesthetic machine did not reveal any obvious reason for this. By auscultation, both lungs appeared to be ventilated although the breath sounds were distant.A sinus tachycardia soon developed, followed by ventricular tachycardia. At this time the patient became slightly cyanotic. The endotracheal tube was withdrawn about 1/2 inch, at which moment complete

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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