Laryngotracheoplasty for Laryngotracheal Stenosis Post Intubation and Post Tracheostomy: A Case of Stenting with Airway Exchange Catheter

2016 ◽  
Vol 102 (2) ◽  
Author(s):  
Deguenonvo REA ◽  
Diouf Ba MS ◽  
Ndiaye C ◽  
Thiam A ◽  
Diop A ◽  
...  
Keyword(s):  
Laryngotracheal Stenosis ◽  
Airway Exchange Catheter ◽  
Exchange Catheter ◽  
Airway Exchange ◽  
Post Intubation

scholarly journals Dislocation rates of nasal versus oral airway exchange catheters for postoperative airway management. A prospective case series of 200 patients

2019 ◽  
Author(s):  
Fredy-Michel Roten ◽  
Richard Steffen ◽  
Maren Kleine-Brueggeney ◽  
Robert Greif ◽  
Marius Wipfli ◽  
...  
Keyword(s):  
Case Series ◽  
University Hospital ◽  
Dislocation Rate ◽  
Airway Extubation ◽  
Airway Exchange Catheter ◽  
Exchange Catheter ◽  
Prospective Case Series ◽  
Postoperative Dislocation ◽  
Airway Exchange ◽  
Pacu Stay

Abstract BACKGROUND: The dislocation rate of oral versus nasal airway exchange catheters (AEC) in the postoperative care unit (PACU) are unknown. Our aim was to establish dislocation rates and to assess the usefulness of waveform capnography to detect dislocation. METHODS: In this non-randomized, prospective observational trial at the University Hospital Bern, Switzerland, we included 200 patients admitted to PACU after extubation via AEC, having provided written informed consent. The study was approved by the local ethical committee. AEC position was assessed by nasal fiberoptic endoscopy at beginning of PACU stay and before removal of the AEC. Capnography was continuously recorded via the AEC. Additional measurements included retching and coughing of the patient, and re-intubation, if necessary. RESULTS: Data from 182 patients could be evaluated regarding dislocation. Overall dislocation rate was not different between oral and nasal catheters (7.2% vs. 2.7%, p=0.16). Retching was more often noted in oral catheters (26% vs. 8%, p<0.01). Waveform capnography was unreliable in predicting dislocation (negative predictive value 17%). Re-intubation was successful in all five of the nine re-intubations where an AEC was still in situ. In four patients, the AEC was already removed when re-intubation became necessary, and re-intubation failed once, with a front of neck access as a rescue maneuver. CONCLUSIONS: We found no difference in dislocation rate between nasal and oral position of an airway exchange catheter. However, nasal catheters seemed to be tolerated better. In the future, catheters like the staged extubation catheter may further increase tolerance. TRIAL REGISTRATION: The study was registered in a clinical study registry (ISRCTN 96726807) on 10/06/2010. KEYWORDS: Airway, extubation, intubation, airway exchange catheter, oral, nasal, postoperative, dislocation.

Extubation of the Difficult Airway

2019 ◽  
Author(s):  
Alison Dalton
Keyword(s):  
At Risk ◽  
Difficult Airway ◽  
Fiberoptic Bronchoscopy ◽  
Airway Exchange Catheter ◽  
Airway Edema ◽  
Exchange Catheter ◽  
Patients At Risk ◽  
Complicating Factors ◽  
Retrograde Intubation ◽  
Airway Exchange

It is well known that induction and intubation are periods associated with patient risk. Especially in the case of patients with known or suspected difficult airways, extubation may be associated with similar risk. Therefore, attempts at extubation must be well planned, and preparations for urgent or emergent intubation must be in order prior to removal of an endotracheal tube. Preparations should be made on a case-by-case basis with consideration given to that specific patient’s indications for difficult airway management. Patients at risk for airway obstruction from edema require different techniques and preparations compared with those patients at risk for intracranial hypertension. Advanced preparations should include consideration of the best location for extubation (ie, OR, PACU, ICU), required tools (ie, airway exchange catheter, videolaryngoscope, fiberoptic bronchoscope supraglottic device), and personnel. A thorough plan for emergent reintubation should be considered taking into account the patient’s baseline airway anatomy, previous difficulty of intubation, subsequent airway edema, hemodynamics, and other complicating factors (ie, patient now in a Halo device, jaw wiring).  This review contains 5 figures, 6 tables, and 45 references. keywords: airway edema, airway exchange catheter, cricothyrotomy, difficult airway, difficult intubation, extubation, fiberoptic bronchoscopy, retrograde intubation

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