MUCOID IMPACTION FOLLOWING NASAL INTUBATION IN A CHILD WITH AN UPPER RESPIRATORY-INFECTION

We describe a case of mucoid impaction following nasotracheal intubati on in a child with an upper respiratory infection that was successfull y treated with a fiberoptic bronchoscope too large to pass through the endotracheal tube lumen. To the best of our knowledge, it is the firs t report in the anesthesia literature in which the placement of a nasa l tracheal tube is implicated as the cause of the mucous obstruction. The physiologic changes that occur with anesthesia and that place pati ents at increased risk for this phenomenon, as well as the differentia l diagnosis, treatment, and prevention of this entity, are discussed. (C) 1998 by Elsevier Science Inc.