Inability to ventilate while using a silicone-based endotracheal tube

Stephen J. Gleich, Wayne T. Nicholson, Travis M. Jacobs, Roger E. Hofer, Juraj Sprung

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


We present a complication associated with herniation of a specially designed silicone-based endotracheal tube (ETT) cuff used for laryngeal nerve monitoring (electromyographic [EMG] ETT). Lung ventilation in our patient was initially unimpeded. However, 30 minutes after initiation of anesthesia with desflurane and nitrous oxide, there was a sudden inability to ventilate due to the herniation of the ETT cuff presumably caused by diffusion of nitrous oxide into the silicone-based cuff. In vitro testing has shown that the increase in intracuff pressure during ventilation with nitrous oxide in the silicone-based EMG ETT is much greater (approximately 50 mmHg) than that in the polyvinyl chloride-based ETT (approximately 10 mmHg) routinely used in our department.

Original languageEnglish (US)
Pages (from-to)389-392
Number of pages4
JournalJournal of Clinical Anesthesia
Issue number5
StatePublished - Aug 2008


  • Anesthesia
  • Cuff herniation
  • Endotracheal tube cuff
  • General
  • Nitrous oxide

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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