Avoidance of laser ignition of endotracheal tubes by wrapping in aluminium foil tape

Abstract

A 12-month-old child with a history of prematurity, severe respiratory compromise and failure to thrive required laser supraglottoplasty for severe laryngotracheobronchomalacia. Maintaining adequate oxygenation intraoperatively proved very difficult. Our usual technique with no endotracheal tube was not possible and CO2 lasering was commenced with a polyvinylchloride endotracheal tube in the operative field. The endotracheal tube was struck by the laser but did not ignite. Concern about the very serious morbidity from a laser-induced fire in the airway prompted a search for possible solutions. No commercially available laser-resistant tube is available in small enough diameter to use in an infant. An aluminium foil tape (3M#425) was evaluated and found to be potentially very useful to protect against an airway fire in this uncommon situation.