Laryngeal Mask Airway or Endotracheal Tube for Percutaneous Dilatational Tracheostomy

Linstedt, Ulf; Zenz, M.; Krull, Kirsten; Hager, D A; Prengel, Andreas W.

doi:10.1213/ane.0b013e3181d27fb4

Cited by 34 publications

(23 citation statements)

References 24 publications

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“…Some previous studies reported that FOB via LMA during PDT may improve both visualization and ventilation [5,6]. Linstedt et al [6] found the LMA group more advantageous in mechanical ventilation and monitorization over ETT group.…”

Section: Discussionmentioning

confidence: 98%

“…The effectiveness (the visualization and identification of relevant airway structures) of EtView TVT or video-assisted FOB via ETT during PDT procedure was evaluated using a standardized 4-step rating scale from 1 to 4 (1: very good; 2: good, mostly visible; 3: poorly visible, mostly unrecognized; 4: any of the anatomic landmarks does not recognized) adopted from Linstedt et al [6]. The following steps were evaluated:…”

Section: Anesthesiamentioning

confidence: 99%

“…Most of these complications are related with lack of airway monitoring or poor visualization during PDT process. Fiberoptic bronchoscopy (FOB) via ETT or a laryngeal mask airway (LMA) is still the most frequent utilized technique for monitoring of this procedure while maintaining mechanical ventilation support [5,6]. Endoscopic guidance has increased the safety of this procedure; nevertheless, the use of a bronchoscope via ETT or LMA potentially may deteriorate ventilation and lead to hypercarbia, hypoxia, and/or alveolar de-recruitment [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of EtView™ tracheoscopic ventilation tube and video-assisted fiberoptic bronchoscopy during percutaneous dilatational tracheostomy

Umutoğlu

Bakan

Topuz

et al. 2016

J Clin Monit Comput

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Fiberoptic bronchoscopy (FOB) via endotracheal tube (ETT) is the most frequent utilized technique for monitoring of percutaneous dilatational tracheostomy (PDT) procedure while maintaining mechanical ventilation. Endoscopic guidance has increased the safety of this procedure; nevertheless, the use of a bronchoscope via ETT potentially may deteriorate ventilation and lead to hypercarbia and/or hypoxia. EtView tracheoscopic ventilation tube (EtView TVT) is a standard endotracheal tube with a camera and light source embedded at the tip. The objectives of this study are to introduce EtView TVT as a monitoring tool during PDT and to compare it with video assisted FOB via ETT. We hypothesized that using EtView TVT during PDT may obtain similar visualization; also may have advantages regarding better mechanical ventilation conditions when compared with video-assisted FOB via ETT. Patients, 18-75 years of age requiring mechanical ventilation scheduled for PDT were randomly allocated into two groups for airway monitorization to guide PDT procedure either with FOB via ETT (Group FOB, n = 12) or EtView TVT (Group EtView, n = 12). After standard anesthesia protocol, alveolar recruitment maneuver was applied and all patients were mechanically ventilated at pressure-controlled ventilation mode with same pressure levels. The primary outcome variable was the reduction in arterial oxygen partial pressure (PaO) values during the procedure. Other respiratory variables and the effectiveness (the visualization and identification of relevant airway structures) of two techniques were the secondary outcome variables. Patients in both groups were comparable with respect to demographic characteristics and initial respiratory variables. Visualization and identification of relevant airway structures in any steps of the PDT procedure were also comparable. The decrease in minute ventilation in Group FOB was higher when compared with Group EtView (51 ± 4 % vs. 12 ± 7.3 %, p < 0.05). The decrease in PaO from initial levels during (34 ± 21 % vs. 5 ± 7 % decrease) and after (26 ± 27 % vs. 2.8 ± 16 % decrease) the procedure was higher in Group FOB when compared with Group EtView (p < 0.05). Considering comparable features in monitorization and advantageous features over mechanical ventilation when compared with video bronchoscopy; EtView TVT would be a good alternative for airway monitorization during PDT especially for patients with poor pulmonary reserve.

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Section: Discussionmentioning

confidence: 98%

Section: Anesthesiamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of EtView™ tracheoscopic ventilation tube and video-assisted fiberoptic bronchoscopy during percutaneous dilatational tracheostomy

Umutoğlu

Bakan

Topuz

et al. 2016

J Clin Monit Comput

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show abstract

“…Before our study, there were only three randomised trials, all of which used first-generation LMA devices and gave conflicting outcomes. Ambesh et al [4] found that the classic LMA was inferior to a tracheal tube, whereas Lindstedt et al [9] and Dosemeci et al [5] found the exact opposite. Our rationale for choosing to study the LMA Supreme against our standard tracheal tube technique was because we were aware that it appeared to perform adequately in terms of oropharyngeal leak pressure and ventilation [10][11][12][13] and our current second generation of LMA, the ProSeal â , was being phased out in our institutions in favour of single-use devices.…”

Section: Discussionmentioning

confidence: 99%

A prospective randomised controlled trial of the LMA Supreme vs cuffed tracheal tube as the airway device during percutaneous tracheostomy

et al. 2014

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“…Routine use of endoscopy during the procedure [31], use of ultrasound to identify midline vessels [32] and use of a laryngeal mask airway (LMA) [33] or ProSeal LMA [34] to improve visibility of intratracheal structures may all improve safety.…”

Section: Problems Relating To Tracheostomymentioning

confidence: 99%

Airway challenges in critical care

2011

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SummaryAirway management in the intensive care unit is more problematic than during anaesthesia. In general, critically ill patients have less physiological reserve and complications are more common, both during the initial airway intervention (which includes risks associated with induction of anaesthesia), and later once the airway has been secured. Despite these known risks, those managing the airway of a critically ill patient, particularly out of hours, may be relatively inexperienced. Solutions to these challenging airway problems include: recognition of those patients with a potential airway problem; implementation of a plan to deal with their airway; immediate availability of a difficult airway trolley; use of capnography for every airway intervention and continuously in all ventilator‐dependent patients; and appropriate training of all intensive care unit staff including use of simulation.

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Laryngeal Mask Airway or Endotracheal Tube for Percutaneous Dilatational Tracheostomy

Cited by 34 publications

References 24 publications

Comparison of EtView™ tracheoscopic ventilation tube and video-assisted fiberoptic bronchoscopy during percutaneous dilatational tracheostomy

Comparison of EtView™ tracheoscopic ventilation tube and video-assisted fiberoptic bronchoscopy during percutaneous dilatational tracheostomy

A prospective randomised controlled trial of the LMA Supreme vs cuffed tracheal tube as the airway device during percutaneous tracheostomy

Airway challenges in critical care

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