| Cannot ventilate-cannot intubate an infant: surgical tracheotomy or transtracheal cannula? | |
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MedLine Citation:
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PMID: 20880155 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: An unanticipated difficult airway is very uncommon in infants. The recommendations for managing the cannot ventilate-cannot intubate (CVCI) situation in infants and small children are based on difficult airway algorithms for adults. These algorithms usually recommend placement of a transtracheal cannula or performing a surgical tracheotomy as a last resort. In this study, we compared the success rate and time used for inserting a transtracheal cannula vs performing a modified surgical tracheotomy in a piglet model. METHODS: We used 10 three-week-old euthanized piglets, weighing eight kilograms each. Thirty physicians had a timed attempt of inserting a transtracheal cannula for jet ventilation. A maximum time of 120 s was allowed. Ten physicians had a timed attempt of performing a modified surgical tracheotomy after a short introduction by an ENT surgeon. The allowed time for this procedure was 240 s. RESULTS: Placement of the transtracheal cannula was successful for eight of 30 physicians. Median time for successful insertion was 68 s. Surgical tracheotomy was successful for 8 of 10 physicians. Median time for successful tracheotomy was 89 s. There was a significantly higher success rate for surgical tracheotomy (P = 0.007). CONCLUSIONS: We found placement of a transtracheal cannula to be significantly less successful than the modified surgical tracheotomy in a piglet model. We question whether placement of a transtracheal cannula should be recommended in infants in a cannot ventilate-cannot intubate situation. |
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Authors:
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Karina Johansen; Rolf J Holm-Knudsen; Birgitte Charabi; Michael S Kristensen; Lars Simon Rasmussen |
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Publication Detail:
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Type: Journal Article Date: 2010-09-29 |
Journal Detail:
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Title: Paediatric anaesthesia Volume: 20 ISSN: 1460-9592 ISO Abbreviation: Paediatr Anaesth Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9206575 Medline TA: Paediatr Anaesth Country: France |
Other Details:
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Languages: eng Pagination: 987-93 Citation Subset: IM |
Copyright Information:
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© 2010 Blackwell Publishing Ltd. |
Affiliation:
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Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. karinakjohansen@hotmail.com |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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