{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T02:06:20Z","timestamp":1763949980229,"version":"3.45.0"},"reference-count":7,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,3]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>We report a rare case of cuff inflation failure in a reinforced nasotracheal tube, despite the pilot balloon being fully inflated. This failure was attributed to the compression of the inflation channel within the tube\u2019s wall, leading to a peritubal air leak and inadequate ventilation. Videolaryngoscopic assessment revealed air bubbles around the tube near the vocal cords, while the cuff remained deflated. The endotracheal tube was replaced using an airway exchange catheter, which improved ventilation. Although previous literature mentions cuff inflation failures due to kinked pilot tubing or pilot balloon defects, this case showed no visible kinks. Cuff inflation was achieved without difficulty initially, but further testing revealed that applying selective pressure to the segment of the inflation channel running through the endotracheal tube\u2019s wall obstructed cuff inflation. A defect in the tube may have allowed this section of the inflation channel to become compressed within the nasal passages.<\/jats:p>","DOI":"10.1136\/bcr-2025-268104","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T02:05:20Z","timestamp":1763949920000},"page":"e268104","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cuff inflation failure of a reinforced nasotracheal tube resulting from occlusion of the embedded inflation lumen"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7862-2182","authenticated-orcid":false,"given":"Arumugam","family":"Vasudevan","sequence":"first","affiliation":[{"name":"Anaesthesiology and Critical Care, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0678-9573","authenticated-orcid":false,"given":"Rajangam","family":"Hariharan","sequence":"additional","affiliation":[{"name":"Anaesthesia and CC, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jemima","family":"Tamilmalar","sequence":"additional","affiliation":[{"name":"Anaesthesiology and Critical Care, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0730-4116","authenticated-orcid":false,"given":"Keerthana","family":"R","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care, JIPMER, Puducherry, PY, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"key":"2025112318051450000_18.11.e268104.1","doi-asserted-by":"crossref","first-page":"293","DOI":"10.4103\/aca.aca_38_24","article-title":"Acute Kinking of Pilot Balloon Tubing-A Rare Complication of Endotracheal Intubation","volume":"27","author":"Padala","year":"2024","journal-title":"Ann Card Anaesth"},{"key":"2025112318051450000_18.11.e268104.2","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1213\/XAA.0000000000001009","article-title":"Pilot Line Kinking Prevents Cuff Deflation: A Case Report","volume":"13","author":"Toyosato","year":"2019","journal-title":"A&A Practice"},{"key":"2025112318051450000_18.11.e268104.3","doi-asserted-by":"crossref","DOI":"10.1186\/s40981-024-00754-9","article-title":"A rare case of endotracheal tube cuff leakage with no detectable decrease in cuff pressure","volume":"10","author":"Nagasawa","year":"2024","journal-title":"JA Clin Rep"},{"key":"2025112318051450000_18.11.e268104.4","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e318292ee21"},{"key":"2025112318051450000_18.11.e268104.5","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2014-207933","article-title":"Difficulty with cuff deflation of reinforced tracheal tube caused by inflation line occlusion with silk thread ligation and fixation","volume":"2015","author":"Gotoh","year":"2015","journal-title":"BMJ Case Rep"},{"key":"2025112318051450000_18.11.e268104.6","doi-asserted-by":"crossref","first-page":"760","DOI":"10.4103\/0019-5049.170044","article-title":"Air leak with intact cuff inflation system: A case report with brief review of literature","volume":"59","author":"Pasupuleti","year":"2015","journal-title":"Indian J Anaesth"},{"key":"2025112318051450000_18.11.e268104.7","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1007\/s12630-025-02953-z","article-title":"Concerns with inflation line position in preformed nasal endotracheal tubes\u2014proximal or distal?","volume":"72","author":"Ravichandrane","year":"2025","journal-title":"Can J Anesth\/J Can Anesth"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268104","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T02:05:22Z","timestamp":1763949922000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":7,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,23]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/bcr-2025-268104"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268104","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}