Brief review: Supplementing oxygen through an airway exchange catheter: efficacy, complications, and recommendations

Difficult Airway Society Guidelines for the management of tracheal extubation

“…Meticulous care must be taken to ensure that the distal tip is positioned in the mid trachea at all times. Oxygen insufflation and high-pressure source (jet) ventilation should only be undertaken with extreme caution as barotrauma and death have been reported [133][134][135][136]. Anaesthetists should be familiar with these devices: training, practice and rehearsal can be achieved using manikin-based scenarios.…”

Airway Management of “At-Risk Extubation'” in Intensive Care

“…Therefore, the distal end of the catheter must be at the middle point of the trachea. Barotrauma and fatal complications of oxygen insufflation and jet ventilation have been reported (41)(42)(43).…”

Strengths and Limitations of Airway Techniques

“…Oxygen supplementation by insufflation, positive pressure, or jet ventilation should be done with great caution as serious complications have been reported. 47 If insufflation is used, only low-flows (eg, 1-2 liters/ minute) should be used; with positive pressure and jet ventilation, every effort should be made to minimize obstruction with delivery of only enough oxygen to forestall lifethreatening hypoxemia. Reintubation with an exchange catheter is greatly facilitated by minimizing the disparity between the inner and outer diameters of the TT and exchange catheters, respectively.…”