Header

UZH-Logo

Maintenance Infos

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


Roten, Fredy-Michel; Steffen, Richard; Kleine-Brueggeney, 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):52.

Abstract

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.

Abstract

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.

Statistics

Citations

Dimensions.ai Metrics
2 citations in Web of Science®
2 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

18 downloads since deposited on 04 Oct 2019
10 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Clinic for Surgery
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Anesthesiology and Pain Medicine
Language:English
Date:11 April 2019
Deposited On:04 Oct 2019 08:56
Last Modified:22 Apr 2020 21:13
Publisher:BioMed Central
ISSN:1471-2253
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1186/s12871-019-0723-9
PubMed ID:30971211

Download

Gold Open Access

Download PDF  'Dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients'.
Preview
Content: Published Version
Filetype: PDF
Size: 627kB
View at publisher