Minimal inflation volume for Combitube Oro-pharyngeal Balloon

Minimal inflation volume for Combitube Oro-pharyngeal Balloon

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Title: Minimal inflation volume for Combitube Oro-pharyngeal Balloon
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Article_Title: Minimal inflation volume for Combitube Oro-pharyngeal Balloon
Authors: Luis A. Gaitini1, Mostafa Somri1, Boris Yanovski1, Sonia J. Vaida2*
Affiliation: 1 B’nai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel
2 Penn State Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
Abstract: Excessive filling of the oro-pharyngeal balloon of the Combitube may predispose to injury of the pharyngeal mucosa. The minimum inflation volume for the oro-pharyngeal balloon that provides an adequate airway seal during spontaneous ventilation was studied. We conclude that cuff volumes substantially less than those recommended by the manufacturer will provide an effective seal by the oropharyngeal balloon of the Combitube during spontaneous ventilation. This may be of importance in avoiding pharyngeal trauma by the Combitube.
Keywords: airway management, Combitube
References: Gaitini L, Vaida S, Agro F. The Esophageal-Tracheal Combitube. Anesthesiology Clinics of North America. 2002; 20:893-906.
Agro FE, Cataldo R, Mattei A. New devices and techniques for airway management. Minerva Anesthesiologica 2009; 75: 141-9.
Gaitini L, Vaida S, Somri M, Yanovski B, Croitoru M, Capdevilla M, Ben David B, Benumof J. The Combitube in elective surgery: a report of 200 cases. Anesthesiology 2001; 94:79-82.
Vézina MC, Trépanier CA, Nicole PC, Lessard MR. Canadian Journal of Anaesthesia 2007 ; 54:124-8
Mallampati SR, Gatt SP, Gugino LD, et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Canadian Anaesthesia Society Journal 1985 ;32:429-434.
Oczenski W, Krenn H, Dahaba AA, et al. Complications following the use of the Combitube, tracheal tube and laryngeal mask airway. Anaesthesia 1999; 54:1161-1165.
O’Kelly SW, Heath KJ, Lawes EG. A study of laryngeal mask inflation. Pressures exerted on the pharynx. Anaesthesia 1993, 48: 1075-1078.
Vézina D, Lessard MR, Bussières J et al. Complications associated with the
use of the Esophageal-Tracheal Combitube. Canadian Journal of Anaesthesia 1998;45:76-80.
Keller C, Brimacombe J, Benzer A. Calculated vs measured pharyngeal mucosal pressures with
the laryngeal mask airway during cuff inflation: assessment of four locations. British Journal of Anaesthsia 1999; 82: 399-401.
Marjot R. Pressure exerted by the laryngeal mask airway cuff upon the pharyngeal mucosa. British Journal of Anaesthsia 1993; 70:25-29.
Mallick A, Quinn AC, Bodenham AR, Vucevic M. Use of the Combitube for airway maintenance during percutaneous dilatational tracheostomy. Anaesthesia 1998; 53: 249-55.
Gaitini LA, Vaida SJ, Somri M, Fradis M, Ben-David B. Fiberoptic-guided airway exchange of the esophageal-tracheal Combitube in spontaneously breathing versus mechanically ventilated patients. Anesthesia and Analgesia 1999; 88:193-196.
Lumb AB, Wrigley MW. The effect of nitrous oxide on laryngeal mask cuff pressure. In vivo and in vitro studies. Anaesthesia 1992; 47: 320-323.
Read_full_article: pdf/vol13/iss3/JMA13-3-10Gaitini.pdf
Correspondence: Sonia Vaida, M.D., Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, 500 University Drive, H187, Hershey, PA 17033-0850, Phone: 717-531-8434 / Fax: 717-531-4204; Email: svaida@hmc.psu.edu

Read full article
Article Title: Minimal inflation volume for Combitube Oro-pharyngeal Balloon
Authors: Luis A. Gaitini1, Mostafa Somri1, Boris Yanovski1, Sonia J. Vaida2*
Affiliation: 1 B’nai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel
2 Penn State Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
Abstract: Excessive filling of the oro-pharyngeal balloon of the Combitube may predispose to injury of the pharyngeal mucosa. The minimum inflation volume for the oro-pharyngeal balloon that provides an adequate airway seal during spontaneous ventilation was studied. We conclude that cuff volumes substantially less than those recommended by the manufacturer will provide an effective seal by the oropharyngeal balloon of the Combitube during spontaneous ventilation. This may be of importance in avoiding pharyngeal trauma by the Combitube.
Keywords: airway management, Combitube
References: Gaitini L, Vaida S, Agro F. The Esophageal-Tracheal Combitube. Anesthesiology Clinics of North America. 2002; 20:893-906.
Agro FE, Cataldo R, Mattei A. New devices and techniques for airway management. Minerva Anesthesiologica 2009; 75: 141-9.
Gaitini L, Vaida S, Somri M, Yanovski B, Croitoru M, Capdevilla M, Ben David B, Benumof J. The Combitube in elective surgery: a report of 200 cases. Anesthesiology 2001; 94:79-82.
Vézina MC, Trépanier CA, Nicole PC, Lessard MR. Canadian Journal of Anaesthesia 2007 ; 54:124-8
Mallampati SR, Gatt SP, Gugino LD, et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Canadian Anaesthesia Society Journal 1985 ;32:429-434.
Oczenski W, Krenn H, Dahaba AA, et al. Complications following the use of the Combitube, tracheal tube and laryngeal mask airway. Anaesthesia 1999; 54:1161-1165.
O’Kelly SW, Heath KJ, Lawes EG. A study of laryngeal mask inflation. Pressures exerted on the pharynx. Anaesthesia 1993, 48: 1075-1078.
Vézina D, Lessard MR, Bussières J et al. Complications associated with the
use of the Esophageal-Tracheal Combitube. Canadian Journal of Anaesthesia 1998;45:76-80.
Keller C, Brimacombe J, Benzer A. Calculated vs measured pharyngeal mucosal pressures with
the laryngeal mask airway during cuff inflation: assessment of four locations. British Journal of Anaesthsia 1999; 82: 399-401.
Marjot R. Pressure exerted by the laryngeal mask airway cuff upon the pharyngeal mucosa. British Journal of Anaesthsia 1993; 70:25-29.
Mallick A, Quinn AC, Bodenham AR, Vucevic M. Use of the Combitube for airway maintenance during percutaneous dilatational tracheostomy. Anaesthesia 1998; 53: 249-55.
Gaitini LA, Vaida SJ, Somri M, Fradis M, Ben-David B. Fiberoptic-guided airway exchange of the esophageal-tracheal Combitube in spontaneously breathing versus mechanically ventilated patients. Anesthesia and Analgesia 1999; 88:193-196.
Lumb AB, Wrigley MW. The effect of nitrous oxide on laryngeal mask cuff pressure. In vivo and in vitro studies. Anaesthesia 1992; 47: 320-323.
*Correspondence: Sonia Vaida, M.D., Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, 500 University Drive, H187, Hershey, PA 17033-0850, Phone: 717-531-8434 / Fax: 717-531-4204; Email: svaida@hmc.psu.edu