Airway Exchange Failure and Complications with the Use of the Cook Airway Exchange Catheter®

Abstract

There are limited data on rates of failure and airway injury with the use of airway exchange catheters. We performed a single-center retrospective analysis of airway exchange catheters to determine the incidence and associated factors for tube exchange failure and airway injury. Among 1177 cases, failed intubation during attempted tube exchange was noted in 73/527 (13.8%). Airway exchange failure rates were greatest during exchange catheter use for double-lumen tube insertion and when intubation was attempted over the catheter postoperatively. Pneumothorax was noted after 1.5% of attempted tube exchanges. Difficult tube exchange was encountered in 6 of 8 patients with pneumothorax.

Pro: Bronchial Blockers Should Be Used Routinely for Providing One-Lung Ventilation

“…10 In a recent study of 1,177 patients, there was a 13.8% incidence of failure to exchange a tube over a tube exchanger, with the highest rate occurring with placement of a double-lumen tube. 11 Initial placement of a single-lumen tube followed by use of a tube exchanger to place a DLT, thus, is thus not a guarantee of success. There also may be a higher degree of minor side effects following the use of a DLT compared with a BB.…”

A modified technique for percutaneous dilatational tracheostomy: A retrospective review of 60 cases

“…Many of the modified techniques require an airway exchange [19,22,23], which is not without complications [26], or replace the patient's ETT with an inferior airway like an LMA [25] or a smaller size ETT [19,22]. The modifications aiming to improve gas exchange either did away with real-time visualization of the needle entering the trachea [4,5,19,22] (with no protection against posterior tracheal wall needle injury [27]) or did not protect against accidental intra-procedural extubation [3-5, 7, 28] as the ETT is left placed precariously near the vocal cords for most of the PDT.…”

Extubación del paciente perioperatorio con una vía aérea difícil

“…Una colocación demasiado profunda pudiera ocasionar perforación de los bronquios y por ende neumotórax, que es la complicación más importante asociada al uso de AEC. Un estudio mostró una tasa del 1,5% de esta complicación 46 . Debido al riesgo de barotrauma, la insuflación de oxígeno o la ventilación a chorro solamente deberán usarse como medida de salvamento y únicamente en presencia de una vía aérea superior no obstruida 6,47,48 .…”