Fiberoptically-Guided Insertion of Transtracheal Catheters

Gerig, Hans J.; Heidegger, Thomas; Ulrich, B.; Grossenbacher, R.; Kreienbuehl, Georg

doi:10.1097/00000539-200109000-00026

Cited by 21 publications

(14 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Significant tracheal compression can occur ahead of the advancing cannula. This complication is more likely to occur if the cannula is inserted into the trachea distal to the cricothyroid membrane [21]. This technique is recommended for Seldinger technique cricothyroidotomy.…”

Section: Discussionmentioning

confidence: 99%

ORIGINAL ARTICLE: Accuracy of surface landmark identification for cannula cricothyroidotomy

Elliott¹,

Baker

Scott³

et al. 2010

Anaesthesia

157

107

View full text Add to dashboard Cite

SummaryCannula cricothyroidotomy is recommended for emergency transtracheal ventilation by all current airway guidelines. Success with this technique depends on the accurate and rapid identification of percutaneous anatomical landmarks. Six healthy subjects underwent neck ultrasound to delineate the borders of the cricothyroid membrane. The midline and bisecting transverse planes through the membrane were marked with an invisible ink pen which could be revealed with an ultraviolet light. Eighteen anaesthetists were then invited to mark an entry point for cricothyroid membrane puncture. Only 32 (30%) attempts by anaesthetists accurately marked the skin area over the cricothyroid membrane. Of these only 11 (10%) marked over the centre point of the membrane. Entry point accuracy was not significantly affected by subjects' weight, height, body mass index, neck circumference or cricothyroid dimensions. Consultant and registrar anaesthetists were significantly more accurate than senior house officers at correctly identifying the cricothyroid membrane. Accuracy of percutaneously identifying the cricothyroid membrane was poor. Ultrasound may assist in identifying anatomical landmarks for cricothyroidotomy.

show abstract

Section: Discussionmentioning

confidence: 99%

ORIGINAL ARTICLE: Accuracy of surface landmark identification for cannula cricothyroidotomy

Elliott¹,

Baker

Scott³

et al. 2010

Anaesthesia

157

107

View full text Add to dashboard Cite

show abstract

“…Gerig et al. reported a series of 154 transtracheal catheters placed under fibreoptic guidance and used for high frequency jet ventilation, noting tension pneumothorax in one patient (0.6%) and pneumomediastinum in two (1.3%) [14]. The authors reported a 15% first attempt failure rate for cannula placement and noted increased tracheal compression during insertion when the puncture site was lower than the cricothyroid membrane (48% producing severe compression, 18% of cannulae abutting the posterior tracheal wall and damage being evident in 2%).…”

Section: Discussionmentioning

confidence: 99%

“…Some authors use transtracheal jet ventilation routinely for a considerable proportion of laryngeal surgery [8, 12, 14], with one group reporting its use for almost 2% of patients requiring tracheal intubation [3]. Others caution against use of transtracheal jet ventilation when ventilation from supraglottic or subglottic catheters (i.e.…”

Section: Discussionmentioning

confidence: 99%

A complication of transtracheal jet ventilation and use of the Aintree intubation catheter^® during airway resuscitation

2006

View full text Add to dashboard Cite

Summary We report the management of a patient requiring surgical laryngoscopy with a view to laser resection of an epiglottic recurrence of laryngeal cancer. Previous attempts at tracheal intubation and awake nasal fibreoptic intubation had failed. During a previous anaesthetic the patient had been both ‘impossible to intubate and to ventilate’. Neck scarring potentially complicated access for transtracheal jet ventilation. Nevertheless, a cricothyroid catheter was placed and surgery performed during low frequency ‘volume’ jet ventilation. Upper airway obstruction developed during the procedure, preventing exhalation, which led to raised intrathoracic pressure, cardiovascular collapse and barotrauma. The airway was re‐established by insertion of an LMA Proseal™. Fibreoptic placement of an Aintree intubation catheter® through this allowed re‐oxygenation and exchange for a cuffed tracheal tube. Some hours after the procedure, re‐intubation was necessary. This was achieved using the Aintree intubation catheter as an aid to nasal fibreoptic intubation and as a tube exchanger. Novel roles of the Aintree intubation catheter and LMA Proseal in this case are discussed. Complications of transtracheal jet ventilation as well as possible methods for avoiding them are also reviewed.

show abstract

“…Als Methode der ersten Wahl bei der "Cannot-intubatecannot-ventilate-Situation" wird die transtracheale Kathetereinlage eingesetzt. Diese Methode wird, wie die fiberoptische Intubation, so oft als möglich in der Routine (unter fiberoptischer Kontrolle) angewendet, damit sie in der Notsituation auch funktioniert [50]. Die transtracheale Kathetereinlage in Lokalanästhesie ist außerdem die Methode der Wahl, wenn die fiberoptische Intubation fehlschlägt oder kontraindiziert ist (z.…”

Section: Standards Richtlinien Leitlinien Algorithmenunclassified

Vergleich von Algorithmen f�r das Management des schwierigen Atemweges

2003

View full text Add to dashboard Cite

Management of the difficult airway and maintenance of the oxygenation are the most important tasks of the anaesthetist. Respiratory problems are still the most important single cause for anaesthesia-related accidents with poor outcome. Algorithms are step-wise procedures developed from a great number of recommendations and are well suited to automation and training procedures. There is strong agreement among consultants that specific strategies lead to improved outcome, although, strictly speaking the degree of benefit on airway management cannot be clearly determined. Several anaesthesia societies, including the American Society of Anesthesiology,have developed their own algorithms for management of the difficult airway. The comparison of published algorithms shows that the management of the anticipated difficult airway has to be performed in the awake patient and fiberoptic intubation is a crucial part of that procedure. There are different techniques (different blades, guide wire, laryngeal mask, fiber optics) for the management of the unanticipated difficult airway. The laryngeal mask, transtracheal access and the Combitube are recommended for the management of the cannot intubate, cannot ventilate situation. More important than the questions which algorithm, which technique and which instruments should be used,is that each department has and practices its own algorithm. This strongly depends on local circumstances and personal preferences. Daily practice is the condition for the successful use in an emergency situation. The management is easier if one uses a simple algorithm and as few instruments as possible.

show abstract

Fiberoptically-Guided Insertion of Transtracheal Catheters

Abstract: Regular use of the transtracheal catheter (TTC) both offers an opportunity for training for the difficult airway and facilitates elective endoscopic surgery. Fiberoptic guidance and exploratory puncture improve the insertion of the TTC.

Cited by 21 publications

References 17 publications

ORIGINAL ARTICLE: Accuracy of surface landmark identification for cannula cricothyroidotomy

ORIGINAL ARTICLE: Accuracy of surface landmark identification for cannula cricothyroidotomy

A complication of transtracheal jet ventilation and use of the Aintree intubation catheter^® during airway resuscitation

Vergleich von Algorithmen f�r das Management des schwierigen Atemweges

Contact Info

Product

Resources

About

Fiberoptically-Guided Insertion of Transtracheal Catheters

Abstract: Regular use of the transtracheal catheter (TTC) both offers an opportunity for training for the difficult airway and facilitates elective endoscopic surgery. Fiberoptic guidance and exploratory puncture improve the insertion of the TTC.

Cited by 21 publications

References 17 publications

ORIGINAL ARTICLE: Accuracy of surface landmark identification for cannula cricothyroidotomy

ORIGINAL ARTICLE: Accuracy of surface landmark identification for cannula cricothyroidotomy

A complication of transtracheal jet ventilation and use of the Aintree intubation catheter® during airway resuscitation

Vergleich von Algorithmen f�r das Management des schwierigen Atemweges

Contact Info

Product

Resources

About

A complication of transtracheal jet ventilation and use of the Aintree intubation catheter^® during airway resuscitation