JOURNAL ARTICLE
REVIEW

Brief review: Supplementing oxygen through an airway exchange catheter: efficacy, complications, and recommendations

Laura V Duggan, J Adam Law, Michael F Murphy
Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie 2011, 58 (6): 560-8
21465321

PURPOSE: An airway exchange catheter (AEC) may be employed as a conduit for endotracheal tube placement and for oxygen insufflation or jet ventilation via its lumen. The recent barotrauma-related death of a young healthy patient receiving oxygen insufflated through an AEC prompted the Chief Coroner of Ontario to seek guidelines regarding their use. A literature search was undertaken using a number of search strategies to investigate both the efficacy and complications associated with supplying oxygen through an AEC.

PRINCIPAL FINDINGS: No studies were found comparing either oxygen insufflation or jet-ventilation through an AEC to any standard forms of oxygen therapy. The only case series found using AEC jet ventilation reported that 11% of patients sustained pulmonary barotrauma. Thirteen case reports documented jet ventilation as being associated with pneumothorax, pneumomediastinum, pneumoperitoneum, cardiovascular collapse, and death. In three case series (totalling 76 adults and 20 children) using only oxygen insufflation, no complications were reported.

CONCLUSIONS: Jet ventilation through an AEC may be associated with a significant risk of barotrauma. Oxygen insufflation appears to be associated with a lower risk, but it is not risk-free. The authors caution against the use of an AEC to administer oxygen failing the proven benefit of its use over the use of standard oxygen therapies. Should a patient decompensate with an AEC in situ, tracheal re-intubation is the key management strategy. Supplemental oxygen can be provided using standard techniques prior to tracheal intubation or between attempts. Under emergency circumstances, oxygen insufflation or manual ventilation through an AEC may be considered provided vigilance for barotrauma is maintained and re-intubation is not delayed.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
21465321
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"