Emergency cricothyrotomy in infants – evaluation of a novel device in an animal model

The ‘Can't Intubate Can't Oxygenate’ scenario in Pediatric Anesthesia: a comparison of different devices for needle cricothyroidotomy

“…In a previous small rabbit study (9), emergency cricothyroidotomy using the Quicktrach Baby TM (VBM Medizintechnik GmbH), of internal diameter 1.5 mm, was successful in ten of ten attempts within 23-43 s. However, the results of our study do not support the use of the larger Quicktrach Child TM (internal diameter 2 mm) in an infant model. The main difference between the present study and the study by Metterlein et al (9) was that their group used the baby Quicktrach cannula, which is shorter and more angled than the child Quicktrach cannula (the only pediatric Quicktrach available in Australia at the time of this study). Metterlein et al studied larger rabbits, with tracheal diameters measuring 5.1-6 mm, equating to a larger pediatric airway (approximately age 4-8 years), so they had both a larger diameter trachea to target and a smaller-sized needle device.…”

“…In a previous small rabbit study , emergency cricothyroidotomy using the Quicktrach Baby ™ (VBM Medizintechnik GmbH), of internal diameter 1.5 mm, was successful in ten of ten attempts within 23–43 s. However, the results of our study do not support the use of the larger Quicktrach Child ™ (internal diameter 2 mm) in an infant model. The main difference between the present study and the study by Metterlein et al .…”

“…The main difference between the present study and the study by Metterlein et al . was that their group used the baby Quicktrach cannula, which is shorter and more angled than the child Quicktrach cannula (the only pediatric Quicktrach available in Australia at the time of this study). Metterlein et al .…”

When can we give general anesthesia to an infant with anticipated difficult airway management caused by facial vascular malformation?

“…Although it is difficult to evaluate the safety of cricothyrotomy devices for infants, Metterlein et al reported successful placement of QuickTrach Baby™ (VBM Medizintechnik GmbH, Sulz am Neckar, Germany) in adult rabbits [4]. However, Stacey et al reported that cannula tracheostomy in a model comparable to an infant’s airway was still difficult and not performed without complication [5]. Because little evidence exists to guide the management of the “can’t intubate, can’t oxygenate” scenario in pediatric anesthesia [1], weight may not predict appropriate timing for general anesthesia in an infant.…”

Percutaneous transtracheal needle insufflation: A useful emergency airway adjunct simply constructed from common items found on your anesthesia cart

“…They are Quicktrach baby (CCR Medical, Jacksonville, FL) and the Ravussin cricothyroid cannula (VBM Medizintechnik, Sulz, Germany). One recent animal study shows Quicktrach baby is a viable option with little risk of posterior wall injury 2. The Ravussin cannula, called Quicktrach I, does have pediatric and infant applications available for approximately $150 per unit.…”