Tracheal Rupture due to Endotracheal Cuff Over inflation in Two Cats

Year 2023, Volume: 2 Issue: 2, 45 - 49, 05.11.2024

Hakan Salcı , Ceren Dolu , Emine Kırım , Hilal Acar

Abstract

The incidence of tracheal rupture in cats is quite low and the rupture usually occurs due to iatrogenic causes. Two cats (1-year-old Scottish Fold and 5-year-old Exotic Shorthair) were urgently presented to our clinics with complaints of dyspnea following ovariohysterectomy and cystotomy operations performed under gas anesthesia at different times. Based on clinical and radiographic findings, a diagnosis of tracheal rupture was made in both cases and the cases were urgently operated for tracheal repair. In both cases, under general anesthesia, the area of tracheal rupture was determined, starting from the thoracic entrance and continuing towards the mediastinum and it was repaired surgically in accordance with the rules. In the postoperative period while complete recovery was observed in the first case, exitus letalis occurred in the second case in the early period. This case report aims to share the clinical findings and surgical results of tracheal rupture caused by overinflation of the endotracheal tube cuff in two different cats.

Keywords

Tracheal rupture, endotracheal cuff pressure, cat

İki Kedide Endotrakeal Kafın Aşırı Şişirilmesine Bağlı Oluşmuş Trakea Rupturu

Abstract

Kedilerde karşılaşılan trakeal rupturun insidansı oldukça düşüktür ve genellikle ruptur iatrojenik nedenli oluşturur. İki kedi (1 yaşlı Scottish Fold ve 5 yaşlı Exotic Shorthair) farklı zamanlarda gaz anestezisi ile gerçekleştirilen ovariohisterektomi ve sistotomi operasyonları sonrasında gelişen dispnea şikâyeti ile acil olarak kliniklerimize sunuldu. Klinik ve radyografik bulgular temelinde her iki olguda trakea rupturu tanısı konuldu ve olgular acilen trakea onarımı için operasyona alındı. Genel anestezi altında her iki olguda torakal girişten başlayıp mediastene doğru devam eden trakea rupturu alanı belirlendi ve kuralına uygun olarak cerrahi teknik ile onarıldı. Postoperatif süreçte birinci olguda tam iyileşme gözlenirken ikinci olguda erken dönemde excitus letalis şekillendi. Bu olgu sunumu ile iki farklı kedide, endotrakeal tüp kafının aşırı şişirilmesine bağlı olarak şekillenen trakeal rupturun klinik bulgularının ve cerrahi sonuçlarının paylaşılması amaçlanmıştır.

Keywords

Trakea rupturu, endotrakeal kaf basıncı, kedi

References

• 1. Raffe M., Bassett R., Tracheal Intubation. In: Creedon J. M. B., Davis H. Editors, Advanced Monitoring and Procedures For Small Animal Emergency and Critical Care, 2. Baskı. John Wiley & Sons., 2023, sayfa:365-375.
• 2. Hardie E., Trachea and bronchus. In: Langley-Hobbs S.J, Demetriou J, Ladlow J. Editors, Feline Soft Tissue and General Surgery, 1. Baskı. W.B. Saunders, 2014, sayfa: 531-540.
• 3. Hecht S., Mediastinum. In: Berry C. R., Nelson N. C., Winter M. D. Editors, Atlas of Small Animal Diagnostic Imaging, 1. Baskı. John Wiley & Sons., 2023, sayfa: 392-443.
• 4. Mitchell S. L, McCarthy R., Rudloff E., Pernell R. T.: Tracheal rupture associated with intubation in cats: 20 cases (1996–1998). J. Am. Vet. Med. Assoc. 2000, 216: 1592–1595.
• 5. Miñambres E., Burón, J., Ballesteros M. A., Llorca J., Muñoz P., González-Castro A. Tracheal rupture after endotracheal intubation: a literature systematic review. Eur. J. CardioThorac. Surg. 2009, 35(6), 1056-1062.
• 6. Salci H., Cetin M., Çeșme H., Topal A., Bayram A. S.: How important is the endotracheal tube cuff pressure? A tracheoscopic evaluation in dogs. Magy. Allatorvosok. 2018, 140 (7), 411-421.
• 7. White R.N., Burton C. A.: Surgical management of intrathoracic tracheal avulsion in cats: long-term results in 9 consecutive cases. Vet. Surg. 2000, 29: 430–435.
• 8. Wilson K. A., Drynan E. A., Raisis A. L., Haitjema G., Hosgood G. L.: Suspected tracheal tear during anaesthesia of a cat. Companion Animal. 2016, 21(11), 614-617.
• 9. MacPhail C. M., Tracheal Surgery. In: Monnet E. Editor, Small Animal Soft Tissue Surgery, John Wiley & Sons, Ltd., 2012, sayfa: 200-209.
• 10. Larson M. M., Trachea. In: Holland M., Hudson J. Editors, Feline Diagnostic Imaging. 1. Baskı, John Wiley & Sons, Ltd, 2020, sayfa: 287-292.
• 11. Klonner M. E., Springer S., Braun C.: Complications secondary to endotracheal intubation in dogs and cats: A questionnaire-based survey among veterinary anaesthesiologists. Vet. Anaesth. Analg. 2023, 50(3), 220-229.
• 12. Hardie E. M., Spodnick G. J., Gilson S.D., Benson J. A., Hawkins E. C.: Tracheal rupture in cats: 16 cases (1983–1998). J. Am. Vet. Med. Assoc. 1999; 214:508 –12.
• 13. Cohen M. R., Maxwell E. A., Gallagher A. E., Portela D. A.: Endoscopic application of fibrin glue may be a feasible method of treatment for postintubation tracheal lacerations in cats. Am. J. Vet. Res. 2023, 84(3), ajvr.22.08.0137.