Five hours after intubation, a circuit leak was noticed. The care team checked the tracheal tube, respiratory circuit, and cuff pressure for potential leaks and found that there was a large crack on the heat and moisture exchanger (Japan Medicalnext, Japan) and a piece of debris beside the patient’s head (fig. 1). After replacing the heat and moisture exchanger with a new one, no leak was detectable and surgery was completed uneventfully. This happened to an adult patient under general anesthesia with a nasal endotracheal tube for tongue resection. Preoperatively, the breathing circuit was checked and no circuit leak was found. The surgeon prepared the neck, face, proximal end of the endotracheal tube, and the distal portion of the circuit including the heat and moisture exchanger with 0.5% hexizac alcohol solution (usually disinfected with iodine solution in...

You do not currently have access to this content.