Utility of airway exchange catheters in pediatric patients with a known difficult airway

Abstract

In children with a known difficult airway who are at risk for a difficult reintubation, the CAEC is a useful tool for a trial of extubation in the intensive care unit.

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

“…15 In the other case, manual ventilation through an AEC caused a pneumothorax. 16 Conversely, no patients suffered barotrauma in the abovementioned three case series involving 76 adult 3,4 and 20 pediatric spontaneously breathing patients 5,6 in whom oxygen insufflation was used at flow rates of 1-8 LÁmin -1 . In Dosemeci's study, 3 18 of 36 patients had an AEC placed in the contralateral nostril along with a nasogastric tube (similar to the case described by McCallum 1 ) yet no patient suffered barotrauma.…”

“…3,4 In a further series of 20 pediatric patients, oxygen insufflation was used at a flow rate of 2-6 LÁmin -1 . 5 Patients in all three series were Supplementing oxygen through an AEC 561 breathing spontaneously, and where reported, 4,5 none suffered oxygen desaturation \ 90%. No cases of barotrauma were reported despite the adult studies being conducted on postoperative patients with known upper airway swelling.…”

Assessment and Management of the Pediatric Airway

“…Several reports have described the use of airway exchange catheters during a trial of extubation in children with known diffi cult airways who are at risk for a diffi cult reintubation [261][262][263][264], although these devices are by no means foolproof. The use of these devices requires that a tracheal tube is already in place, although they are mentioned here as part of the diffi cult airway armamentarium.…”

A Child With a Difficult Airway

“…A number of reports have been published using various devices in innovative ways (non-FDA approved) to serve as an exchange catheter in preparation for a potential reintubation. 40 Reintubation was accomplished using the airway exchange catheter as a guide to repass the endotracheal tube. 37,38 Conversion from oral intubation to nasal intubation in children has also been described.…”