Laryngeal Mask Airway for Airway Control during Percutaneous Dilatational Tracheostomy

Pratt, Tom; Bromilow, J.

doi:10.1177/0310057x1103900605

Cited by 8 publications

(4 citation statements)

References 21 publications

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“…After a thorough literary investigation, we could not fi nd a study designed similarly to the present one. Most studies focus on ventilation comparing laryngeal mask airway versus endotracheal intubation as airway device used during percutaneous tracheostomy, but none compares hemodynamic parameters [3,4,5]. Some studies assess the effi cacy of laryngeal mask airway (LMA) ventilation in patients with airway stenosis [6] and report no major or minor complications.…”

Section: Discussionmentioning

confidence: 99%

Laryngeal Mask Ventilation during Tracheostomy Improves Intraoperative Hemodynamic Stability in Patients Undergoing Total Laryngectomy

Marinov

Popov

Belitova

2019

Acta Medica Bulgarica

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Background and objectives: Laryngectomy with extensive extirpational neck dissection is still the treatment of choice for patients with advanced laryngeal cancer. During the initial part of laryngectomy – tracheostomy, there is a significant upper airway obstruction, caused by the cancer process itself and worsened by surgical pressure and manipulation during creation of tracheostomy. This study aims to make comparative assessment of the patient’s hemodynamic parameters, operated using three of the most popular approaches during tracheostomy: local anesthesia with preserved spontaneous ventilation; general anesthesia with ventilation by endotracheal intubation and general anesthesia with ventilation by laryngeal mask airway. Methods: A prospective cohort study was conducted in a tertiary referral center. Sixty patients with advanced laryngeal cancer appointed for total laryngectomy, were enrolled in the study. They were randomly assigned into three groups, according to the ventilation method used during the tracheostomy. Results: Patients who underwent tracheostomy under local anesthesia displayed statistically the highest levels of SAP, DAP, MAP and heart rate intraoperatively. The group of patients who underwent tracheostomy with endotracheal intubation, also displayed significantly higher levels of hemodynamic parameters during the procedure compared with the group with laryngeal mask airway ventilation, despite the fact that both groups were under general anesthesia. Conclusions: To our knowledge, this is the first study to demonstrate that laryngeal mask ventilation during tracheostomy improves intraoperative hemodynamic stability in patients undergoing total laryngectomy compared to endotracheal intubation.

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Section: Discussionmentioning

confidence: 99%

Laryngeal Mask Ventilation during Tracheostomy Improves Intraoperative Hemodynamic Stability in Patients Undergoing Total Laryngectomy

Marinov

Popov

Belitova

2019

Acta Medica Bulgarica

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“…The present study compared three methods, tracheostomy, 13 percutaneous dilatational tracheostomy, 14 and cricothyrotomy 15 for factors such as duration of the procedure, complications (earlier and late), and instruments needed for each procedure. All three procedures were performed by an otolaryngologist during the emergency calls.…”

Section: Methodsmentioning

confidence: 99%

“…Tracheostomy: 13 The tracheostomy procedure was first documented in history around 1546 B.C. for peritonsillar Percutaneous tracheostomy: 14 The challenges of airway establishment also depend upon the operating room time and on the burden of transporting critically ill patients, which was the impetus behind developing a quick, safe, and reliable alternative to open tracheostomy. Toye et al 17 first described percutaneous tracheostomy using the Seldinger technique in 1969, and remained in practice until Ciaglia 18 introduced the dilatational percutaneous technique in 1985.…”

Section: Interventionsmentioning

confidence: 99%

Cricothyrotomy - In Unanticipated Difficult Intubation Cases with Respiratory Compromise

Sathiyabama

2024

Int Arch Otorhinolaryngol

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Introduction Cricothyrotomy, percutaneous dilation tracheostomy, and tracheostomy are all cost-effective and safe techniques used in the management of critically ill patients who need an artificial airway other than endotracheal tube ventilation. The present study focused on enlightening on elective and emergency procedures performed on conditions present with difficult airways and also attempts to shed light on the aspects of securing an airway in anticipated and unanticipated difficult intubation. Objective The objective of the study was to compare the three procedures conducted during difficult airway/failed intubation situations. Methods The present retrospective observational study was conducted collecting data from patient files obtained at a tertiary healthcare center from 2013 to 2018. The difficult intubation cases were managed by ear, nose, and throat (ENT) surgeons. The study compared three methods: Cricothyrotomy, percutaneous dilation tracheostomy, and tracheostomy based on factors such as procedure duration, complications, and the instruments required for each procedure. Results The study enrolled 85 patients, 61 males and 24 females, aged between 30 and 70 years old. To perform cricothyrotomy, only a simple blade was required. Cricothyrotomy had the shortest operating time (4.1±3.1 minutes) and the shortest time of full oxygen saturation (3 min). Percutaneous tracheostomy had the least amount of bleeding (1%). Cricothyrotomy significantly showed the least intraoperative bleeding than percutaneous dilation, tracheostomy, and tracheostomy (p = 0.001). Conclusion Cricothyrotomy is preferable as it takes less time to perform, causes less bleeding, and takes the least time for full oxygen saturation than tracheostomy and percutaneous dilatational tracheostomy in “can't intubate, can't oxygenate” patients.

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“…Third, in the cases of previously placed tracheal stents, the rigid bronchoscope provides a large visual field and minimizes the chance for dislodgement or compression of the stents. Furthermore, in patients with complex airways, the rigid bronchoscope provides a secure airway with excellent views without risk of cuff puncture or inadvertent dislodgement of the endotracheal tube (28). Finally, in patients with coagulopathy, the rigid bronchoscope allows easy hemostatic control.…”

Section: Brief Communicationmentioning

confidence: 99%

Evaluation of Rigid Bronchoscopy–Guided Percutaneous Dilational Tracheostomy. A Pilot Study

Majid

Cheng²,

Kent³

et al. 2014

Annals ATS

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Laryngeal Mask Airway for Airway Control during Percutaneous Dilatational Tracheostomy

Cited by 8 publications

References 21 publications

Laryngeal Mask Ventilation during Tracheostomy Improves Intraoperative Hemodynamic Stability in Patients Undergoing Total Laryngectomy

Laryngeal Mask Ventilation during Tracheostomy Improves Intraoperative Hemodynamic Stability in Patients Undergoing Total Laryngectomy

Cricothyrotomy - In Unanticipated Difficult Intubation Cases with Respiratory Compromise

Evaluation of Rigid Bronchoscopy–Guided Percutaneous Dilational Tracheostomy. A Pilot Study

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