Adjusting the endotracheal tube tip in management of tracheomalacia in an infant.

Tracheomalacia (TM) is an occult central airway problem that may block the endotracheal tube (ETT) tip and cause ventilation risk. Traditional physical examination, chest radiograph, end-tidal CO2 monitoring and blood gas analysis do not easily make the correct diagnosis. Ultra-thin flexible bronchoscopy (FB) is convenient and useful to verify this rare type of ETT obstruction and can also guide the adjustment of the ETT tip to a correct location. We report two TM infants who were successfully diagnosed and managed by FB to correctly reposition the ETT tip.