Poor performance of the pediatric airway exchange catheter in adults with cervical spine immobilization

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Duk-Kyung KimJae-Sung Ryu

Abstract

Use of a pediatric airway exchange catheter (PAEC) has been advocated as a potentially useful adjunct for difficult extubations. We evaluated the laryngeal passing ability of a tracheal tube over a PAEC and compared its success rate between adult patients in the sniffing position and adult patients with simulated cervical spine immobilization created using a manual in-line axial stabilization (MIAS) technique. A total of 100 adult patients were randomized into two groups of equal size with respect to position during the simulated reintubation trial: the MIAS position (Group M) and the sniffing position (Group S). After induction of anesthesia, an 11-F PAEC was placed in the trachea under direct laryngoscopic view, and a wire-reinforced tube (with its bevel facing to the left) was gently railroaded over the PAEC and into the trachea. If insertion was impeded, a second attempt was made after rotating the tube 90 degrees counterclockwise. If this also failed, one additional attempt was made using external laryngeal pressure before changing to conventional laryngoscopic intubation. After the second attempt, the cumulative success rates in Groups M and S were 41.3% and 72.3%, respectively (P = 0.003). After three attempts, the overa...Continue Reading

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Oct 26, 2007·Anesthesia and Analgesia·Peter Biro, Hans-Joachim Priebe

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Citations

Jan 11, 2013·Anesthesia and Analgesia·Laura F Cavallone, Andrea Vannucci

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