Use of a Shortened Endotracheal Tube as a Tracheostomy Tube in a Morbidly Obese Patient

Abstract

The rising prevalence of morbidly obese patients presents unique challenges to the intensivist, including management of the airway. We present a case where commercially available tracheostomy tubes were of insufficient length due to the patient's body habitus, with potentially disastrous consequences. As a solution, an endotracheal tube was used as the tracheostomy tube to provide sufficient length for correct positioning and to enable weaning from mechanical ventilation. The adjustable flange from a tracheostomy kit was used to secure the tube in position. Our case illustrates one possible solution to the problem of tracheostomy tube positioning in morbidly obese patients.