Document Detail


Intubating laryngeal mask as a ventilatory device during percutaneous dilatational tracheostomy: a descriptive study.
MedLine Citation:
PMID:  17933797     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We use an intubating laryngeal mask (ILM) in preference to an endotracheal tube (ETT) as the ventilatory device during percutaneous dilatational tracheostomy (PDT) to overcome potential problems such as difficult ventilation, accidental extubation, damage of the ETT or of the bronchoscope, and need for additional assistant to secure the airway. We report our experience with this method. METHODS: In this prospective observational study, PDT was performed using the ILM in 86 patients. The insertion of the ILM, the quality of ventilation, and the view of the tracheal puncture site were rated as: 'very good', 'good', 'difficult', and 'not possible with ILM'. RESULTS: The bronchoscope was not damaged during any case, and all PDTs were performed by two physicians, without the need for an additional assistant. PDTs with ILM were successful in 95% of the patients (n=82). The ratings were 'very good' or 'good' in 80% of cases with regards to ventilation, in 90% for identification of relevant structures and tracheal puncture site, and in 85% for the view inside the trachea during PDT. Tracheal re-intubation was required for inadequate ventilation with ILM in four patients. CONCLUSIONS: The advantages of this procedure were lack of damage to the bronchoscope, the need for two instead of three persons to perform the PDT, and the excellent view inside the trachea. We recommend the ILM as a standard device for ventilation during bronchoscope-guided PDT.
Authors:
U Linstedt; F Möller; N Grote; M Zenz; A Prengel
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2007-10-12
Journal Detail:
Title:  British journal of anaesthesia     Volume:  99     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-16     Completed Date:  2007-12-12     Revised Date:  2008-04-15    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  912-5     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, Intensive Care Medicine, and Pain Therapy, Diako Hospital, Flensburg, Academic Teaching Hospital of the University of Kiel, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bronchoscopy
Humans
Intubation, Intratracheal / methods*
Laryngeal Masks*
Middle Aged
Prospective Studies
Respiration, Artificial
Surgical Procedures, Minimally Invasive / methods
Tracheostomy / methods*
Comments/Corrections
Comment In:
Br J Anaesth. 2008 Apr;100(4):562-3; author reply 563-4   [PMID:  18357642 ]
Br J Anaesth. 2008 Apr;100(4):561-2; author reply 563-4   [PMID:  18344575 ]

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