Intraoperative Repair of Pilot Balloon Inflation Line Damage: A Practical Solution to Tube Replacement
Hacı Yusuf Günes, Aslan AydinDepartment of Anesthesiology, Faculty of Medicine, Yuzuncu Yil University, Van, TurkeyObjective:
Intraoperative damage to the pilot balloon inflation line of an endotracheal tube (ETT) can result in cuff deflation, leading to ineffective ventilation and increased aspiration risk. This case report describes a practical repair technique that allowed continued safe ventilation without tube replacement.
Case Presentation:
A 70-year-old woman underwent elective coronary artery bypass grafting. During central venous catheter placement, the anesthesia machine displayed low EtCO₂ and ventilator failure alarms. Diminished bilateral breath sounds were noted, and the pilot balloon was found severed. As the patient's hemodynamics remained stable, a 20G intravenous catheter steel needle tip was inserted directly into the inflation line, carefully positioned to avoid further damage. The cuff was reinflated using a syringe, and appropriate pressure was maintained with a three-way stopcock and cuff manometer. The air leak resolved, and surgery proceeded without requiring tube exchange.
Conclusion:
Pilot balloon damage can be safely managed intraoperatively using readily available equipment. This practical approach may serve as a valuable alternative to endotracheal tube replacement, especially in cases involving a difficult airway. Familiarity with such repair methods can enhance airway safety during surgery.
Manuscript Language: English