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  • Print publication year: 2011
  • Online publication date: October 2011

Chapter 11 - Airway manipulation with tracheotomy

Summary

Percutaneous tracheotomy (PT) is beneficial in decreasing dead space and reducing airway resistance when compared with intubation. Absolute contraindications include the need for an emergent airway or inability to intubate the patient. All current PT methods are based upon the Seldinger technique of dilators placed over a guidewire. It is recommended that PT be performed under simultaneous video bronchoscopy. Techinques for PT are: Ciaglia method (percutaneous dilating technique), Griggs technique (guidewire dilating forceps (GWDF) technique), Fantoni's technique (translaryngeal approach), and PercTwist (screw-action dilator). Two important issues specific to PT that may arise during the course of the procedure are accidental penetration of the endotracheal tube cuff with the introducer needle during initial puncture of the anterior tracheal wall and possible dislocation of the endotracheal tube. The most common immediate postoperative complication is bleeding. Long-term complications have been reported extensively in a number of studies and metaanalyses.

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References

1. KraenzlerEJ, RiceTW, SteinSL, InslerSR. Bilateral bronchial blockers for bilateral pulmonary resections in a patient with a previous laryngectomy. J Cardiothorac Vasc Anesth 1997; 11: 201–2.
2. VretzakisG, TheodorouE, MikroulisD. Endobronchial blockade through a tracheostomy tube for lung isolation. Anesth Analg 2008; 107: 1644–5.
3. VeitAM, AllenRB. Singlelung ventilation in a patient with a freshly placed percutaneous tracheostomy. Anesth Analg 1996; 82: 1292–3.
4. CamposJH. Which device should be considered best for lung isolation: double lumen endotracheal tube versus bronchial blockers. Curr Opin Anaesthesiol 2007; 20: 27–31.
5. CohenE. Pro: the new bronchial blockers are preferable to double-lumen tubes for lung isolation. J Cardiothorac Vasc Anesth 2008; 22: 920–4.
6. SlingerP. Con: The new bronchial blockers are not preferable to double-lumen tubes for lung isolation. J Cardiothorac Vasc Anesth 2008; 22: 925–9.
7. KaziST, AliMA, DonohoeBO. Accidental oro-endotracheostomy intubation. Anaesthesia 2006; 61: 918–19.
8. KasierEF, SeschacharAM, PopovichMJ. Tracheostomy tube placement: role of airway exchange catheter. Anesthesiology 2001; 94: 718–19.
9. McguireG, El-BeheiryH, BrownD. Loss of the airway during tracheostomy: rescue oxygenation and re-establishment of airway. Can J Anesth 2001; 48: 697–700.
10. SimpsonPM. Tracheal intubation with a Robertshaw tube via a tracheostomy. Br J Anesth 1976; 48: 373–5.
11. SeedRF, WedleyJR. Tracheal intubation with a Robertshaw tube via tracheostomy. Br J Anesth 1977; 44: 639.
12. SotoRG, OleszakSP. Resection of the Arndt Bronchial Blocker during stapler resection of the left lower lobe. J Cardiothorac Vasc Anesth 2006; 20: 131–2.