CLINICS

Clinics (Sao Paulo). 2017 July; 72(7): 422-425.
doi:10.6061/clinics/2017(07)06

Copyright © 2017 CLINICS

Laryngeal tube suction for airway management during in-hospital emergencies

Haitham Mutlak I * , Christian Friedrich Weber I , Dirk Meininger I III , Colleen Cuca I , Kai Zacharowski I , Christian Byhahn II , Richard Schalk I

Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Goethe-University Hospital, Theodor-Stern Kai 7-10, 60590 Frankfurt, Germany

Department of Anesthesiology and Intensive Care Medicine, Medical Campus, University of Oldenburg, Evangelisches Krankenhaus, Steinweg 13-17, 26122 Oldenburg, Germany

Department of Anesthesiology, Main-Kinzig-Kliniken, Herzbachweg 14, 63571 Gelnhausen, Germany

*Corresponding author. E-mail: haitham.mutlak@kgu.de

received March 7, 2017; revised April 4, 2017; accepted May 15, 2017.

Abstract

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.

Keywords: Difficult Airway Management, Laryngeal Tube, Supraglottic Airway Devices, In-Hospital Emergencies


Articles from Clinics are provided here courtesy of
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

2nd © Copyright 2007 - Revista Clinics - All rights reserved