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 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.
Verfasserangaben: | Haitham MutlakORCiDGND, Christian Friedrich WeberORCiDGND, Dirk MeiningerORCiDGND, Colleen CucaORCiDGND, Kai ZacharowskiORCiDGND, Christian ByhahnGND, Richard Schalk |
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URN: | urn:nbn:de:hebis:30:3-773952 |
DOI: | https://doi.org/10.6061/clinics/2017(07)06 |
ISSN: | 1807-5932 |
Titel des übergeordneten Werkes (Englisch): | Clinics |
Verlag: | Elsevier |
Verlagsort: | Amsterdam |
Dokumentart: | Wissenschaftlicher Artikel |
Sprache: | Englisch |
Datum der Veröffentlichung (online): | 27.05.2022 |
Jahr der Erstveröffentlichung: | 2017 |
Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Datum der Freischaltung: | 31.10.2023 |
Freies Schlagwort / Tag: | Difficult Airway Management; In-Hospital Emergencies; Laryngeal Tube; Supraglottic Airway Devices |
Jahrgang: | 72 |
Ausgabe / Heft: | 7 |
Seitenzahl: | 4 |
Erste Seite: | 422 |
Letzte Seite: | 425 |
HeBIS-PPN: | 514480513 |
Institute: | Medizin |
DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Lizenz (Deutsch): | Creative Commons - CC BY - Namensnennung 4.0 International |