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Cuffed versus uncuffed tracheal tubes in a rabbit training model for establishing an emergency Front of Neck Airway in children: A prospective trial

Alonso, Elena. Cuffed versus uncuffed tracheal tubes in a rabbit training model for establishing an emergency Front of Neck Airway in children: A prospective trial. 2021, University of Zurich, Faculty of Medicine.

Abstract

Background
There is a paucity of evidence regarding the optimal type of tracheal tube to be advanced over a Frova catheter when performing a ‘bougie’ emergency front-of-neck airway (eFONA) technique in infants during a ‘cannot intubate, cannot oxygenate’ situation.
Methods
A prospective non-inferiority trial in a rabbit cadaver surgical tracheotomy model to assess the performance of the eFONA technique with an uncuffed 3.5 mm ID tracheal tube vs a cuffed 3.0 mm ID tracheal tube. Queried outcomes include success rate, performance time, and severe secondary airway injuries among tracheal tube types.
Results
In 60 tracheostomies performed by 30 participants, the overall success rate was 98%. Performance time was independent from tracheal tube choice (uncuffed: 61 s [95% confidence interval (CI), 52–76], cuffed: 64 s [95% CI, 55–79]; P = 0.82). No tracheal tube type was preferred in terms of usability by participants. The cuffed tracheal tube required increased force to be advanced over the Frova catheter and was associated with a risk ratio of 2.5 (95% CI, 0.53–11.9; number needed to harm, 10) for severe secondary airway injuries when compared with the uncuffed tracheal tube.
Conclusion
In performing eFONA in the rabbit cadaver model, an ID 3.5 uncuffed is non-inferior to an ID 3.0 cuffed tracheal tube regarding performance time and preference by the operator. Greater force application to advance the cuffed tube over the Frova catheter and more severe airway injuries may argue for the standardised performance of the eFONA technique with a uncuffed tracheal tube in infants.

Additional indexing

Item Type:Dissertation (monographical)
Referees:Both Christian Peter, Baumgartner Matthias
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
UZH Dissertations
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2021
Deposited On:28 Jan 2022 11:48
Last Modified:28 Jan 2022 11:49
OA Status:Closed
Related URLs:https://www.zora.uzh.ch/id/eprint/212729/
https://www.bjanaesthesia.org/article/S0007-0912(21)00745-5/fulltext
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