Dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients.

Roten, Fredy-Michel; Steffen, Richard; Kleine-Brüggeney, Maren; Greif, Robert; Wipfli, Marius; Arnold, Andreas; Fischer, Henrik; Theiler, Lorenz (2019). Dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients. BMC anesthesiology, 19(1), p. 52. BioMed Central 10.1186/s12871-019-0723-9

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BACKGROUND The dislocation rate of oral versus nasal airway exchange catheters (AEC) in the postoperative care unit (PACU) are unknown. Our aim was to establish dislocation rates and to assess the usefulness of waveform capnography to detect dislocation. METHODS In this non-randomized, prospective observational trial at the University Hospital Bern, Switzerland, we included 200 patients admitted to PACU after extubation via AEC, having provided written informed consent. The study was approved by the local ethical committee. AEC position was assessed by nasal fiberoptic endoscopy at beginning of PACU stay and before removal of the AEC. Capnography was continuously recorded via the AEC. Additional measurements included retching and coughing of the patient, and re-intubation, if necessary. RESULTS Data from 182 patients could be evaluated regarding dislocation. Overall dislocation rate was not different between oral and nasal catheters (7.2% vs. 2.7%, p = 0.16). Retching was more often noted in oral catheters (26% vs. 8%, p < 0.01). Waveform capnography was unreliable in predicting dislocation (negative predictive value 17%). Re-intubation was successful in all five of the nine re-intubations where an AEC was still in situ. In four patients, the AEC was already removed when re-intubation became necessary, and re-intubation failed once, with a front of neck access as a rescue maneuver. CONCLUSIONS We found no difference in dislocation rate between nasal and oral position of an airway exchange catheter. However, nasal catheters seemed to be tolerated better. In the future, catheters like the staged extubation catheter may further increase tolerance. TRIAL REGISTRATION The study was registered in a clinical study registry ( ISRCTN 96726807 ) on 10/06/2010.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Roten, Fredy-Michel; Steffen, Richard; Kleine-Brüggeney, Maren; Greif, Robert and Theiler, Lorenz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1471-2253

Publisher:

BioMed Central

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

25 Jun 2019 15:45

Last Modified:

22 Oct 2019 18:04

Publisher DOI:

10.1186/s12871-019-0723-9

PubMed ID:

30971211

Uncontrolled Keywords:

Airway Airway exchange catheter Dislocation Extubation Intubation Nasal Oral Postoperative

BORIS DOI:

10.7892/boris.130327

URI:

https://boris.unibe.ch/id/eprint/130327

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