Hemodynamic and Catecholamine Stress Responses to Insertion of the Combitube[registered sign], Laryngeal Mask Airway or Tracheal Intubation

Abstract

In this study, we showed that the hemodynamic and catecholamine stress responses after insertion of the Combitube (Kendall-Sheridan Catheter Corp., Argyle, NY) were significantly higher compared with laryngeal mask airway or endotracheal intubation. We conclude that the increased stress response to insertion of a Combitube may represent a serious hazard to patients with cardiovascular disease.

ProSeal Laryngeal Mask Airway Attenuates Systemic and Cerebral Hemodynamic Response During Awakening of Neurosurgical Patients

“…2,6 Hemodynamic control and the avoidance of coughing or any Valsalva maneuver are key elements of optimal management during emergence, especially in these high-risk patients. 5,[9][10][11][12][13][14] Those differences are even more intense during emergence and extubation. 1,7,8 Orotracheal intubation is the standard technique for intraoperative control of the airway during neurosurgery.…”

Haemodynamic and catecholamine stress responses to the Laryngeal Tube‐Suction Airway and the Proseal Laryngeal Mask Airway

“…Airway devices that cause a reduced stress response could be beneficial in patients with cardiovascular disease. Supraglottic devices are generally thought to cause minimal stress responses; however, this might not necessarily be true as some supraglottic devices, especially those with large oropharyngeal cuffs have been shown to provoke an increase in mean arterial pressure (MAP) that might be considerably greater than that found following tracheal intubation [3]. In addition, the removal of these devices may also cause a stress response.…”

Atemwegsmanagement durch nicht-ärztliches Personal

“…Die Atemwegssicherung gelang mit der Larynxmaske am schnellsten, wobei der Unterschied zur langsamsten Alternative, dem Combitube, mit 5,1 s zwar nicht unerheblich, klinisch aber nach Ansicht der Autoren vernachlässigbar ist, da auch hier der durchschnittliche Zeitbedarf mit 21,7 s weit innerhalb des akzeptierten Zeitfensters für die Atem- [15].Wurden die Zeiten bis zur ersten erfolgreichen Ventilation gemessen, stiegen die Zeitunterschiede zwischen Larnyxmaske und Combitube z. T. erheblich an [16]. Im Vergleich zur endotrachealen Intubation ließen sich bezüglich des durchschnittlichen Zeitbedarfs signifikante Unterschiede für Larynxmaske und Combitube berechnen (p<0,01), der Zeitunterschied zwischen Intubation und Larynx-Tubus war nicht signifikant.…”