Complications associated with the use of the Esophageal-Tracheal Combitube

Vézina, Daniel P.; Lessard, Martin; Bussières, Jean S.; Topping, Claude; Trépanier, Claude A.

doi:10.1007/bf03011999

Cited by 108 publications

(25 citation statements)

References 12 publications

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“…Other possible complications related to the use of the esophageal-tracheal tube are esophageal trauma, including lacerations, bruising, and subcutaneous emphysema. 45,50,51 Laryngeal Tube The advantages of the laryngeal tube (Laryngeal Tube or King LT) are similar to those of the esophageal-tracheal tube; however, the laryngeal tube is more compact and less complicated to insert (unlike the esophageal-tracheal tube, the laryngeal tube can only go into the esophagus). At this time there are limited data published on the use of the laryngeal tube in cardiac arrest.…”

Section: Esophageal-tracheal Tubementioning

confidence: 99%

Part 8: Adult Advanced Cardiovascular Life Support

Neumar¹,

Otto²,

Link³

et al. 2010

Circulation

1,341

872

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Section: Esophageal-tracheal Tubementioning

confidence: 99%

Part 8: Adult Advanced Cardiovascular Life Support

Neumar¹,

Otto²,

Link³

et al. 2010

Circulation

1,341

872

View full text Add to dashboard Cite

“…[7][8][9] Many serious complications, including but not limited to aspiration pneumonitis, pneumothorax, pneumomediastinum, airway injuries, esophageal lacerations and perforations have been reported with the Combitube. 6,10,11 However, limited data on the incidence and severity of these complications are available, in spite of its widespread acceptance in the pre-hospital setting. 3 The primary objective of this retrospective chart review was to determine the incidence of the complications associated to the Combitube in the prehospital setting.…”

Section: Discussionmentioning

confidence: 99%

Complications associated with the Esophageal-Tracheal Combitube® in the pre-hospital setting

Vézina

Trépanier

Nicole

et al. 2007

Can J Anesth/J Can Anesth

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Purpose:The Esophageal-Tracheal Combitube® (Combitube) is widely used for the management of the airway during cardiopulmonary resuscitation in the pre-hospital setting. Although serious complications have been reported with the Combitube, there is a paucity of data relative to the frequency and nature of such complications. The objective of this retrospective study was to determine the incidence and the nature of complications associated to the Combitube in the pre-hospital setting.Methods: Since 1993, in the Quebec City Health Region, the basic life support treatment algorithm for emergency medical technicians has included the use of a Combitube as the primary airway device for management of all patients presenting with cardiac or respiratory arrest. The database of the emergency coordination services was searched for the period between 1993 and 2003 (2,981 patients). Only those patients who survived at least 12 hr were included. Medical records of these patients were reviewed to identify complications related to the use of the Combitube.Results: Two-hundred-eighty (280) patients were identified. Fifty-eight (58) patients (20.7%, confidence interval (CI) 95% = 16.0%-25.4%) presented 69 complications: aspiration pneumonitis (n = 31), pulmonary aspiration (n = 16), pneumothorax (n = 6), upper airway bleeding (n = 4), esophageal laceration (n = 3), sc emphysema (n = 2), esophageal perforation and mediastinitis (n = 2), tongue edema (n = 2), vocal cord injury (n = 1), tracheal injury (n = 1), and pneumomediastinum (n = 1). Thirteen of these complications (12 patients, 4.3%, CI 95% = 2.0%-6.3%) were judged as most likely resulting from trauma associated with insertion of the Combitube. Conclusion:The use of the Combitube in the pre-hospital setting is associated with a notable incidence of serious complications. Résultats : patients ont été inclut. 7 %, intervalle de confiance (IC) 95 % = 16,0-25,4 %) ont présenté 69 complications : pneumonie d'aspiration (n = 31), aspiration bronchique (n = 16), pneumothorax (n = 6), saignement des voies aériennes supérieures (n = 4), lacérations oesophagiennes (n = 3), emphysème sc (n = 2), perforation oesophagienne et médiastinite (n = 2), oedème de la langue (n = 2), lésion aux cordes vocales (n = 1), lésion trachéale (n = 1), pneumomédiastin (n = 1). Treize de ces complications (12 patients,4,3 % 4,3 %, IC 95% = 2,[0][1][2][3][4][5][6]3 %)

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“…In a 1998 study of 1,139 cardiac arrest patients, four cases of subcutaneous emphysema, pneumomediastinum, and pneumoperitoneum associated with the Combitube by EMTs during prehospital management were reported. 40 The reason for these complications appears to be hyperinflation of the distal balloon (20 to 40 mL) and may also be attributable to external chest compression and continuous positive-pressure ventilation. 41 …”

Section: Disadvantages Contraindications and Complicationsmentioning

confidence: 99%