A 16-year-old female was operated for maxillary fracture under general anesthesia. She has no past medical history and preoperative investigations, chest X-ray and ECG were normal. After induction, tracheal intubation with positive pressure ventilation was performed. Anesthesia was maintained with oxygen 2 litre /min, N2O 2L/min, and 2.5 vol% sevoflurane. The vitals were stable and oxygen saturation was 99%. Midway through the procedure, during oral irrigation with povidone-iodine, bubbles were noticed.
The Mallinckrodt tube was removed and a damage which caused air leak was identified. The patient developed a fall in oxygen saturation from 99% to 96% and a rale was auscultated on the right lung field. On tracheal suction, a frothy discharge was seen. An arterial blood gas analysis showed FiO2 0.5, pH 7.34, PaCO2 42.9 mmHg, PaO2 69.4 mmHg, and SaO2 93%. A chest X-ray was taken and…
