Review of Tracheo-Esophageal Fistula Associated with Endotracheal Intubation

Tracheo-esophageal fistula (TEF) formation is a rare complication of either endotracheal intubation or tracheostomy. This complication is generally thought to be iatrogenic and occurs in less than 1% of patients. High-volume, low-pressure cuffs have made TEFs an infrequent occurrence; however, it still poses as a potential life-threatening condition. Evaluation and close monitoring of endotracheal tube (ETT) cuff pressures is an area of significance commonly overlooked and/or underemphasized by surgical residents. To illustrate and review this clinical problem, a case of an iatrogenic TEF as a consequence of excessive endotracheal cuff pressures is reported.

Key Words: tracheo-esophageal fistula, endotracheal intubation, ventilator management, endotracheal tube complications

Competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice Based Learning and Improvement