A prospective study of the safety of tracheal extubation using a pediatric airway exchange catheter for patients with a known difficult airway

Chest
E P LoudermilkP B Langevin

Abstract

To determine the usefulness of routinely inserting a hollow airway exchange catheter (jet stylet) prior to tracheal extubation of adult patients with risk factors for difficult tracheal intubation. Prospective, 1-year study of 40 consecutive patients undergoing mechanical ventilation who had one or more risk factors for difficult tracheal reintubation. Surgical ICU of a tertiary university medical center. Study patients at risk for difficult tracheal reintubation were extubated using a No. 11 Cook airway exchange catheter (CAEC). Following tracheal extubation, the CAEC was secured, and humidified oxygen was insufflated through the central lumen (2 to 8 L/min) for a minimum of 4 h, during which oxyhemoglobin saturation (SpO2) and respiratory frequency were monitored. Stridor or other signs of respiratory difficulty were also assessed. The CAEC was removed when it became clinically apparent that the need for tracheal reintubation was unlikely. When patients failed to respond to tracheal extubation, the CAEC was used to facilitate reintubation of these difficult airways. Respiratory distress necessitating tracheal reintubation occurred in 3 of 40 patients (8%). One patient failed to respond to tracheal extubation twice. None of th...Continue Reading

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Citations

Jan 14, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Duk-Kyung KimJae-Sung Ryu
Aug 10, 2006·Journal of Anesthesia·Dane A Hassani, Sanjay M Bhananker
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