Iatrogenic Tracheal Injury during Cardiac Surgery

A 59-year-old man was taken up for coronary artery bypass graft surgery.After an uneventful anesthetic induction and intubation with a cuffed endotracheal tube (ETT) of internal diameter 8.5 mm, the surgeon used electrocautery in the suprasternal space for the division of the interclavicular ligament before sternotomy.At this point, a low tidal-volume alarm from the anesthesia machine was noted, and end-tidal carbon dioxide tracing suddenly became flat.e breathing circuit tubing and its connectors were found intact.e surgeon noticed an air leak sound and air bubbles coming out from the trachea.