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Correspondence  |   July 1997
Reply  : Kinking of the Proximal End of a Nasal RAE Tube after Intubation via Laryngeal Mask Airway
Author Notes
  • Professor of Anesthesia, UCSD Medical Center, 402 Dickinson Street, San Diego, California 92103–8812.
Article Information
Correspondence
Correspondence   |   July 1997
Reply  : Kinking of the Proximal End of a Nasal RAE Tube after Intubation via Laryngeal Mask Airway
Anesthesiology 7 1997, Vol.87, 185. doi:
Anesthesiology 7 1997, Vol.87, 185. doi:
In Reply:-I very much appreciate Dr. Preis's thoughtful comments and agree with all of them. I had previously been unaware of the existence of the Holder Ulm Pattern; based on Dr. Preis's letter, I also agree that this device is a more general and functional solution to the problem of kinking of the proximal end of a nasal RAE tube inserted through a LMA. However, and as a relatively minor additional consideration, stabilization of the proximal end of the nasal RAE tube by a tightly tensioned connection to a nonmoveable fixation point incurs the risk of accidental extubation if the head (and airway) is turned or moved away from the fixation point. As with the use of a metal “Christmas tree” holder, a loosely tensioned connection of the endotracheal tube to the support minimizes the risk of accidental extubation by allowing the existing slack to compensate for sudden increases in distance between the airway and the fixation point on the support.
Jonathan L. Benumof, M.D.
Professor of Anesthesia; UCSD Medical Center; 402 Dickinson Street; San Diego, California 92103–8812
(Accepted for publication April 25, 1997.)