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Airway Management During Tracheostomy

Conventional Device Laryngeal Mask Airway Double Lumen Endotracheal Tube

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Percutaneous Tracheostomy in Critically Ill Patients
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Abstract

A number of percutaneous tracheostomy (PDT) techniques have been developed across the years. The different techniques and devices appeared largely equivalent, with the exception of retrograde tracheostomy. Conventionally, the airway management during PDT has been managed by a single lumen endotracheal tube (ETT). PDT may be performed with laryngeal mask airway (LMA) if the operators are confident with this procedure. LMA may overcome the problem of accidental extubation during PDT because it is stably cuffed during the procedure. Double-lumen endotracheal tube (DLET) for PDT has been recently proposed by literature. DLET is divided in an upper channel, for placement of bronchoscope, and a lower channel exclusively dedicated to patients’ ventilation.

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References

  1. Cheung NH, Napolitano LM. Tracheostomy: epidemiology, indications, timing, technique, and outcome. Respir Care. 2014;59(6):895–919.

    Article  PubMed  Google Scholar 

  2. Vargas M, Servillo G, Arditi E, Brunetti I, Pecunia L, Salami D, Putensen C, Antonelli M, Pelosi P. Tracheostomy in Intensive Care Unit: a national survey in Italy. Minerva Anestesiol. 2013;79:156–64.

    CAS  PubMed  Google Scholar 

  3. Vargas M, Pelosi P, Servillo G. Percutaneous tracheostomy: it’s time for a shared approach! Crit Care. 2014;8:448.

    Article  Google Scholar 

  4. Vargas M, Servillo G, Tessitore G, Aloj F, Brunetti I, Arditi E, Salami D, Kacmarek RM, Pelosi P. Double lumen endotracheal tube for percutaneous tracheostomy. Respir Care. 2014;59:1652–9. doi:10.4187/respcare.03161.

    Article  PubMed  Google Scholar 

  5. Hsia D, DiBlasi RM, Richardson P, Crotwell D, Debley J, Carter E. The effect of flexible bronchoscopy on mechanical ventilation in a paediatric lung model. Chest. 2009;135(1):33–40.

    Article  PubMed  Google Scholar 

  6. Reilly PM, Sing RF, Giberson FA, Anderson 3rd HL, Rotondo MF, Tinkoff GH, Schwab CW. Hypercarbia during tracheostomy: a comparison of percutaneous endoscopic, percutaneous Doppler and standard surgical tracheostomy. Intensive Care Med. 1997;23(8):859–64.

    Article  CAS  PubMed  Google Scholar 

  7. Simon M, Metscheke M, Braune SA, Puschel K, Kluge S. Death after percutaneous dilatational tracheostomy: a systematic review and analysis of risk factors. Crit Care. 2013;17:R258.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Linstedt U, Moller F, Grote N, Zenz M, Prengel A. Intubating laryngeal mask as a ventilatory device during percutaneous dilatational tracheostomy: a descriptive study. Br J Anaesth. 2007;99(6):912–5.

    Article  CAS  PubMed  Google Scholar 

  9. Linstedt U, Zenz M, Krull K, Häger D, Prengel AW. Laryngeal mask airway or endotracheal tube for percutaneous dilatational tracheostomy: a comparison of visibility of intratracheal structures. Anesth Analg. 2010;110(4):1076–82.

    Article  PubMed  Google Scholar 

  10. Pacheler SR, Byhahn KJF, Siebenhofer A, Weberscock T. Laryngeal mask airway versus endotracheal tube for percutaneous dilatational tracheostomy in critically ill adult patients. Cochrane Database System Rev. 2014;(6):CD009901.

    Google Scholar 

  11. Vargas M, Pelosi P, Tessitore G, Aloj F, Brunetti I, Arditi E, Salami D, Kacmarek RM, Servillo G. Percutaneous dilatational tracheostomy with a double lumen endotracheal tube for. Chest. 2015;147(5):1267–74.

    Article  PubMed  Google Scholar 

  12. Kaiser E, Cantais E, Goutorbe P, Salinier L, Palmier B. Prospective randomized comparison of progressive dilational vs forceps dilational percutaneous tracheostomy. Anaesth Intensive Care. 2006;34(1):51–4.

    CAS  PubMed  Google Scholar 

  13. Montcriol A, Bordes J, Asencio Y, Prunet B, Lacroix G, Meaudre E. Bedside percutaneous tracheostomy: a prospective randomised comparison of PercuTwist versus Griggs’ forceps dilational tracheostomy. Anaesth Intensive Care. 2011;39(2):209–16.

    CAS  PubMed  Google Scholar 

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Correspondence to G. Servillo .

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© 2016 Springer International Publishing Switzerland

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Vargas, M., Perrone, A., Servillo, G. (2016). Airway Management During Tracheostomy. In: Servillo, G., Pelosi, P. (eds) Percutaneous Tracheostomy in Critically Ill Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-22300-1_13

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  • DOI: https://doi.org/10.1007/978-3-319-22300-1_13

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22299-8

  • Online ISBN: 978-3-319-22300-1

  • eBook Packages: MedicineMedicine (R0)

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