Laryngeal mask airway versus endotracheal tube for percutaneous dilatational tracheostomy in critically ill adult patients

Strametz, Reinhard; Pachler, Christoph; Kramer, J. Harald; Byhahn, Christian; Siebenhofer, Andrea; Weberschock, Tobias

doi:10.1002/14651858.cd009901.pub2

Cited by 19 publications

(8 citation statements)

References 42 publications

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“…Some of these problems could be the mortality all case (Fernandez, 2005) (10), procedurerelated mortality, duration of the procedure, failing to do the procedure and changing it to an alternative, extubation time after tracheostomy, and duration of hospitalization of patient after tracheostomy, which had no significant difference between the 2 methods in different studies. Furthermore, there was no significant difference between the 2 groups in the case of serious side effects such as the loss of airway, which didn't occur in any group (FernandezLindsted 2010) (10) and also in case of cardiac arrest during PDT.…”

Section: Discussionmentioning

confidence: 89%

“…In a study by Linsted (2010), it was reported that only 1 case of studies has been done on pneumonia aspiration, in which there was no report about pneumonia aspiration (after 24 hours) (10). In case of mediastinitis, only 2 studies were done after this method; also, they had no deal with mediastinitis after PDT in 24 hours (Fernandez-Linsted) (8,10,11 In studies, there should be a great attention on the side effects such as gastric distention, mild bleeding, arrhythmia, desaturation, subcutaneous emphysema, and tracheal stenosis, which were mentioned in the study group (SGA).…”

Section: Discussionmentioning

confidence: 99%

“…In case of mediastinitis, only 2 studies were done after this method; also, they had no deal with mediastinitis after PDT in 24 hours (Fernandez-Linsted) (8,10,11 In studies, there should be a great attention on the side effects such as gastric distention, mild bleeding, arrhythmia, desaturation, subcutaneous emphysema, and tracheal stenosis, which were mentioned in the study group (SGA). However, the responses in this case were contradictory and required further studies (11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

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Airway Management during MS-PDT Using I-GEL: A Case Report

et al. 2016

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Introduction: Percutaneous Dilated Tracheostomy by Minimally Invasive Surgery has been used as a bedside method. It can be helpful to replace ETT with a supra glotic airway device like, LMA or Igel to perform this technique appropriately. Such work has been done with LMA in previous studies. This is the first report on the use of Igel to keep the airway during MS-PDT. Case Presentation: The patient was a 36-year-old man who was diagnosed with HIV/AIDS. He was admitted due to symptoms of shortness of breath and its progress in form of respiratory distress. According to the prolonged duration of treatment and prevention of long-term complications of intubation, a tracheostomy was planned as an elective by using the Minimally Invasive Surgery-PDT method. The airway management during MS-PDT was performed by I GEL as a supraglotic airway device. Conclusion: This study was very keen on working with Igel as a useful insertion tool compared with LMA. This report would be the beginning of future works in PDT by Igel.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Airway Management during MS-PDT Using I-GEL: A Case Report

et al. 2016

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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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“…There is no difference in the rate of complications, but the tracheostomies involving LMAs seemed to be quicker, may be due to less time to adjust the ETT cuff above the cords [30].…”

Section: Evidence For and Against The Use Of Lmas In Critical Carementioning

confidence: 91%

Airway Management in ICU Settings

Shallik¹,

Almustafa²,

Zaghw³

et al. 2017

Intensive Care

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Maintenance of patent airway, adequate ventilation, and pulmonary gas exchange is very important in critically ill patients. Airway management in intensive care patients differs significantly from routine surgical procedures in the operating room. The airway competence in intensive care unit (ICU) should be coping with the rapidly evolving advances in airway management. Therefore, efforts should be focused on the three pillars of airway master: airway providers as intensivists or critical care physicians, equipment, and operational plans. Not all institutions can afford all airway equipment in the market; however, they should make sure that critical care providers have a full access to the available tools and they are comfortable using it. Educational sessions and refresher courses should be tailored to meet the competence level of the ICU providers and equipment availability. Operational plan includes developing institutional airway protocols and implementing difficult airway guidelines. The protocols should consider different staffing models of ICU and make sure all the time at least one member of the team with the highest experience in airway should be always available. The aim of writing this chapter is to enable the intensivist to optimize their use of airway equipment and managing highrisk patients in ICU.Keywords: tracheal intubation, videolaryngoscopy (VL), flexible fiberoptic intubation, bronchoscopy, percutaneous tracheostomy, extubation in ICU, high-flow nasal cannula (HFNC), virtual endoscopy (VE), airway ultrasound, supra-glottic airway devices, tube exchange © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Tracheal intubation in ICU IntroductionTracheal intubation (TI) is one of daily practiced procedures in the intensive care unit (ICU), especially when the patient has respiratory failure or cardiovascular collapse. It involves highly skilled techniques that require much of training, practice, and expertise. The excellence in airway management in ICU is necessary for intensivist's every day practice, which when it is lacking does not only compromise the quality of care but also has a potential impact on patient safety.The optimal intubation condition prevailing in surgical theaters differs a lot in nature than harsh and chaotic scenarios in ICU. The nature of those situations has three factors: the highly skilled anesthesiologists versus the intensivists; the compensated, well-controlled surgical patient versus the decompensated sick ICU patients; and equipment availability. That is why in ICU settings, the airway instrumentation-related complications have higher incidence than anesthesia settings. Among the contributory factors for high failure rates are the highly stressful environment, limited expertise level of the providers with different te...

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Laryngeal mask airway versus endotracheal tube for percutaneous dilatational tracheostomy in critically ill adult patients

Abstract: Laryngeal mask airway versus endotracheal tube for percutaneous dilatational tracheostomy in critically ill adult patients.

Cited by 19 publications

References 42 publications

Airway Management during MS-PDT Using I-GEL: A Case Report

Airway Management during MS-PDT Using I-GEL: A Case Report

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

Airway Management in ICU Settings

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