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Korean Journal of Anesthesiology 2008;55(2):221-225.
DOI: https://doi.org/10.4097/kjae.2008.55.2.221   
Hemoptysis and obstruction of the endotracheal tube by blood clot in a pediatric patient: A case report.
Ji Young Bae, Chul Ho Woo, Min seok Yang, Sung Ha Mun, In Suk Kwak, Kwang min Kim
1Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Korea. woochmd@lycos.co.kr
2Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University, Seoul, Korea.
Hemoptysis leading to airway obstruction by blood clot is a serious and potentially lethal condition in pediatric patients because of the unpredictable course and technical difficulty of managing small airways. An 11-month-old male patient with a contact burn on his left foot was intubated uneventfully during induction for general anesthesia. After 15 minutes, we noted blood in his endotracheal tube along with high airway pressure and desaturation. Immediate suction was performed, and the oxygen saturation recovered, but the airway pressure and small exhaled tidal volume were unchanged. We had difficulty differentiating endotracheal tube obstruction from bronchial spasm at that time. We successfully managed the endotracheal obstruction by extubation with removal of the blood clot and reintubation after the diagnosis was made using fiberoptic bronchoscopy. We review the etiology and management of airway obstruction and hemoptysis in the operating room.
Key Words: airway obstruction; hemoptysis; intubation; pediatric anesthesia


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