Background and goal of study: 
This case report portrays the risk of post-intubation tracheal stenosis in patients under GA with ET placement. The objective is to show one of the most feared complications of ET tube placement without cuff pressure monitoring and its impact on patient’s life quality. 

Materials and methods: 
A 59-year-old woman with Crohn’s disease who was subjected to multiple GA with ET placement without cuff monitorization, developed progressive dyspnea and stridor over the last one and half year. It was detected a subglottic tracheal stenosis at bronchoscopy which was followed by dilatation and prosthesis placement.
After three more flexible fibroscopies and due to the persistent complaints, she was subjected to another bronchoscopy with prosthesis removal. The patient is still under medical supervision and can do her daily activity but with some limitations.






Discussion: 
Every patient proposed to GA with ET placement without cuff monitorization present a risk of developing post-intubation tracheal stenosis (due to the risk of tracheal wall ischemia by cuff compression followed by fibrosis) which has a huge impact on their quality of life due to the high probability of recurrence and the limiting symptomatology it causes.
Patients with comorbidities such diabetes, CV disease, obesity, smoking are in highest risk. This case report tries to sensitize the medical community the importance of ET cuff monitorization (between 20 to 30mmHg) because in spite of being a rare condition, when happens it can be so limiting to the patient’s life.

References: 
1. De, S., & De, S. (2008). Post intubation tracheal stenosis. Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 12(4), 194–197. http://doi.org/10.4103/0972-5229.45081; 2. Gelbard A, Francis DO, Sandulache VC, Simmons JC, Donovan DT, Ongkasuwan J. Causes and consequences of adult laryngotracheal stenosis. Laryngoscope. 2015;125:1137–1143; 

Learning points: 
Despite the developing medical industry on trying to give us the best and least invasive products (like ET with low pressure-high volume cuffs), we need to be always precautious and try to offer the best treatment to our patient, thereby minimizing iatrogeny.

12 / Post-intubation tracheal stenosis: monitoring is essential!