Correspondence  |   February 2007
Questioning the Length of Airway Exchange Catheters
Author Affiliations & Notes
  • Maged Argalious, M.D., M.Sc.
  • *The Cleveland Clinic, Cleveland, Ohio.
Article Information
Correspondence   |   February 2007
Questioning the Length of Airway Exchange Catheters
Anesthesiology 2 2007, Vol.106, 404. doi:
Anesthesiology 2 2007, Vol.106, 404. doi:
To the Editor:—
The recent letter by Fetterman et al.  on esophageal misplacement of a size 14-French Cook airway exchange catheter (Cook Critical Care, Bloomington, IN) highlights potential complications of this equipment.1 We believe that the length of these catheters may be excessive. Cook airway exchange catheter sizes 11-, 14-, and 19-French have a length of 83 cm; however, because they are intended for use with single-lumen endotracheal tubes, we believe that a length of approximately 56 cm (double the length of most adult single-lumen endotracheal tubes and the same length as the Cook Aintree catheter) is all that is really needed.
Many of the complications associated with airway exchange catheter use result from overly deep placement of these catheters2; a length of 83 cm far exceeds the length necessary for safe endotracheal tube exchange and may lead to overly deep airway exchange catheter placement by inexperienced users who inadvertently ignore the guide marks. Whereas we realize that a length of 56 cm can still allow for complications, we believe that reducing the length of these catheters may help to reduce the incidence of such complications. Finally, we would like to echo the authors’ recommendations on capnographic confirmation of tracheal airway exchange catheter placement.
*The Cleveland Clinic, Cleveland, Ohio.
Fetterman D, Dubovoy A, Reay M: Unforeseen esophageal misplacement of airway exchange catheter leading to gastric perforation. Anesthesiology 2006; 104:1111–2Fetterman, D Dubovoy, A Reay, M
Benumof J: Airway exchange catheters: Simple concept. Potential danger. Anesthesiology 1999; 91:342–4Benumof, J