Laryngeal tube suction for airway management during in-hospital emergencies
OBJECTIVE: The role of supraglottic airway devices in emergency airway management is highlighted in international airway management guidelines. We evaluated the application of the new generation laryngeal tube suction (LTS-II/LTS-D) in the management of in-hospital unexpected difficult airway and ca...
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doaj-141a170635404954b598bb523be36d5c2020-11-25T01:33:18ZengFaculdade de Medicina / USPClinics1980-532272742242510.6061/clinics/2017(07)06S1807-59322017000700422Laryngeal tube suction for airway management during in-hospital emergenciesHaitham MutlakChristian Friedrich WeberDirk MeiningerColleen CucaKai ZacharowskiChristian ByhahnRichard SchalkOBJECTIVE: The role of supraglottic airway devices in emergency airway management is highlighted in international airway management guidelines. We evaluated the application of the new generation laryngeal tube suction (LTS-II/LTS-D) in the management of in-hospital unexpected difficult airway and cardiopulmonary resuscitation. METHODS: During a seven-year period, patients treated with a laryngeal tube who received routine anesthesia and had an unexpected difficult airway (Cormack Lehane Grade 3-4), who underwent cardiopulmonary resuscitation, or who underwent cardiopulmonary resuscitation outside the operating room and had a difficult airway were evaluated. Successful placement of the LTS II/LTS-D, sufficient ventilation, time to placement, number of placement attempts, stomach content, peripheral oxygen saturation/end-tidal carbon dioxide development (SpO2/etCO2) over 5 minutes, subjective overall assessment and complications were recorded. RESULTS: In total, 106 adult patients were treated using an LTS-II/LTS-D. The main indication for placement was a difficult airway (75%, n=80), followed by cardiopulmonary resuscitation (25%, n=26) or an overlap between both (18%, n=19). In 94% of patients (n=100), users placed the laryngeal tube during the first attempt. In 93% of patients (n=98), the tube was placed within 30 seconds. A significant increase in SpO2 from 97% (0-100) to 99% (5-100) was observed in the whole population and in cardiopulmonary resuscitation patients. The average initial etCO2 of 39.5 mmHg (0-100 mmHg) decreased significantly to an average of 38.4 mmHg (10-62 mmHg) after 5 minutes. A comparison of cardiopulmonary resuscitation patients with non-cardiopulmonary resuscitation patients regarding gastric contents showed no significant difference. CONCLUSIONS: LTS-D/LTS-II use for in-hospital unexpected difficult airway management provides a secure method for primary airway management until other options such as video laryngoscopy or fiber optic intubation become available.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322017000700422&lng=en&tlng=enDifficult Airway ManagementLaryngeal TubeSupraglottic Airway DevicesIn-Hospital Emergencies |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Haitham Mutlak Christian Friedrich Weber Dirk Meininger Colleen Cuca Kai Zacharowski Christian Byhahn Richard Schalk |
spellingShingle |
Haitham Mutlak Christian Friedrich Weber Dirk Meininger Colleen Cuca Kai Zacharowski Christian Byhahn Richard Schalk Laryngeal tube suction for airway management during in-hospital emergencies Clinics Difficult Airway Management Laryngeal Tube Supraglottic Airway Devices In-Hospital Emergencies |
author_facet |
Haitham Mutlak Christian Friedrich Weber Dirk Meininger Colleen Cuca Kai Zacharowski Christian Byhahn Richard Schalk |
author_sort |
Haitham Mutlak |
title |
Laryngeal tube suction for airway management during in-hospital emergencies |
title_short |
Laryngeal tube suction for airway management during in-hospital emergencies |
title_full |
Laryngeal tube suction for airway management during in-hospital emergencies |
title_fullStr |
Laryngeal tube suction for airway management during in-hospital emergencies |
title_full_unstemmed |
Laryngeal tube suction for airway management during in-hospital emergencies |
title_sort |
laryngeal tube suction for airway management during in-hospital emergencies |
publisher |
Faculdade de Medicina / USP |
series |
Clinics |
issn |
1980-5322 |
description |
OBJECTIVE: The role of supraglottic airway devices in emergency airway management is highlighted in international airway management guidelines. We evaluated the application of the new generation laryngeal tube suction (LTS-II/LTS-D) in the management of in-hospital unexpected difficult airway and cardiopulmonary resuscitation. METHODS: During a seven-year period, patients treated with a laryngeal tube who received routine anesthesia and had an unexpected difficult airway (Cormack Lehane Grade 3-4), who underwent cardiopulmonary resuscitation, or who underwent cardiopulmonary resuscitation outside the operating room and had a difficult airway were evaluated. Successful placement of the LTS II/LTS-D, sufficient ventilation, time to placement, number of placement attempts, stomach content, peripheral oxygen saturation/end-tidal carbon dioxide development (SpO2/etCO2) over 5 minutes, subjective overall assessment and complications were recorded. RESULTS: In total, 106 adult patients were treated using an LTS-II/LTS-D. The main indication for placement was a difficult airway (75%, n=80), followed by cardiopulmonary resuscitation (25%, n=26) or an overlap between both (18%, n=19). In 94% of patients (n=100), users placed the laryngeal tube during the first attempt. In 93% of patients (n=98), the tube was placed within 30 seconds. A significant increase in SpO2 from 97% (0-100) to 99% (5-100) was observed in the whole population and in cardiopulmonary resuscitation patients. The average initial etCO2 of 39.5 mmHg (0-100 mmHg) decreased significantly to an average of 38.4 mmHg (10-62 mmHg) after 5 minutes. A comparison of cardiopulmonary resuscitation patients with non-cardiopulmonary resuscitation patients regarding gastric contents showed no significant difference. CONCLUSIONS: LTS-D/LTS-II use for in-hospital unexpected difficult airway management provides a secure method for primary airway management until other options such as video laryngoscopy or fiber optic intubation become available. |
topic |
Difficult Airway Management Laryngeal Tube Supraglottic Airway Devices In-Hospital Emergencies |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322017000700422&lng=en&tlng=en |
work_keys_str_mv |
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