Introduction
This clinical case study describes the highly unusual situation where a
horse was not able to be extubated without the aid of a tracheostomy
assisted extubation. A similar case study has been described in the dog
where extubation was assisted via a tracheostomy (Grzywa & Barker,
2022). It is interesting to note that the majority of similar case
reports describe the use of either silicone (Romano & Portela, 2020;
Sanchis Mora & Seymour, 2011) or red rubber tubes (Grzywa & Barker,
2022). There was one report in a cat where a reused polyvinyl chloride
tube was difficult to remove and required the instillation of extra
lubrication around the ET cuff (Norgate & Jimenez, 2017). The cuff in
this instance was bunched-up thus increasing the effective outer
diameter of the ET tube. Could the wider cuff profile of high-volume,
low-pressure polyvinyl chloride endotracheal tubes encourage people to
use smaller tubes? This is something I have observed in several
university clinical practices however it is hard to estimate how it
influences general veterinary practice.
This clinical case study not only describes the situation associated
with the ET tube becoming lodged in the trachea but also how the authors
achieved the successful removal of the ET tube. Both aspects have
clinical relevance to practitioners of anaesthesia. Some of the
clinically pertinent aspects of this case study will be discussed in
further detail below, followed by clinical recommendations.