Airway Management Device (AMD^TM) for airway control in percutaneous dilatational tracheostomy

Percutaneous dilational tracheostomy: a safer technique of airway management using a microlaryngeal tube

“…Other methods of managing the airway during percutaneous tracheostomy have been described. These include the laryngeal mask airway (LMA™) [7], the intubating LMA™[8], the Combitube™[9, 10], the airway management device (AMD™) [11] and a tracheal ventilation catheter [12]. However, none of these methods provides a totally secure airway.…”

A new device has to be safe and reliable too

“…This device has been marketed recently. As there was no published evidence of its efficacy and safety (except one case report [1]), a decision was made to undertake an audit project to address these issues. Fifty ASA 1 and 2 patients undergoing various surgical procedures under general anaesthesia were included in this project.…”

“…A high intracuff pressure may compromise circulation of the tongue, especially in association with systemic hypotension, which is not uncommon under general anaesthesia. Concern has also been expressed over the possibility of lingual nerve damage [1]. Any one of these complications could be potentially serious and all of them are related to high intracuff pressure.…”

The Airway Management Device; is it not similar to the Combitube?

“…The list of complications encountered in this study suggests its overall poor performance. There has been to date no published literature on the use of this device except a case report during percutaneous tracheostomy [1]. However, I would like to raise several points.…”

“…The use of the Combitube therefore is more or less limited to emergency situations. The cuffs of the Combitube can generate very high pressures at the air seal and can lead to bluish discoloration of the tongue [1, 6]. Cook's study has now demonstrated this to happen with the AMD.…”