Keller C, Elliott W, Hubbell R N
Division of Otolaryngology-Head and Neck Surgery, University of Vermont, Burlington.
Arch Otolaryngol Head Neck Surg. 1992 Jun;118(6):643-5. doi: 10.1001/archotol.1992.01880060093019.
A case report of an endotracheal tube fire occurring during electrodissection tonsillectomy is presented. The authors believe that this incident occurred because a retrograde leak of ventilating gases around an uncuffed endotracheal tube during positive-pressure ventilation produced a high oxygen concentration in the mouth, allowing indirect ignition of the tube. In vitro testing supported this hypothesis. Ignition tests on polyvinylchloride endotracheal tubes using electrocautery in various oxygen concentrations were performed. As oxygen concentration increased, the endotracheal tube could be moved further from the cautery and still allow ignition of the tube. At 52% oxygen, with the cautery set at 25-W coagulation current, the endotracheal tube could not be ignited. Recommendations to prevent a recurrence of this incident are included.
本文报告了一例在电切扁桃体切除术期间发生气管内导管起火的病例。作者认为，该事件的发生是因为在正压通气期间，无套囊气管内导管周围的通气气体逆行泄漏，导致口腔内氧气浓度升高，从而间接点燃了导管。体外测试支持了这一假设。对聚氯乙烯气管内导管在不同氧气浓度下使用电灼进行了点火测试。随着氧气浓度的增加，气管内导管可以离电灼器更远，但仍可被点燃。在氧气浓度为52%、电灼器设置为25瓦凝固电流的情况下，气管内导管无法被点燃。文中还包括了防止该事件再次发生的建议。
