Difficult tracheal extubation due to endotracheal tube malfunction: A challenge during the COVID-19 pandemic

Bamgbade, Olumuyiwa A.; Magboh, Vivian O.; Otegbeye, Ajibola U.; King, Mmakgomo B.; Oluwole, Olusanya J.; Olatunji, Bolusefe T.

Tracheal extubation is an aerosol-generating medical procedure. A difficult tracheal extubation results in a serious complication that increases the risk of respiratory aerosol and pathogen spread, especially during the COVID-19 pandemic. The management of difficult extubation is potentially even more challenging during the pandemic. We report two cases of difficult extubation due to endotracheal tube cuff malfunction during the COVID-19 pandemic. Special airway maneuvers and infection control measures were employed to successfully manage the unexpected dilemma. This case series highlights the risk of COVID-19 virus transmission during difficult extubation. This report describes the preventive and reactive management of difficult extubation.