L Lazarre Ogden, James A. Bradway; Airway Obstruction in a Prone Patient. Anesthesiology 2009;110(3):686. doi: 10.1097/ALN.0b013e318198712e.
Download citation file:
© 2019 American Society of Anesthesiologists
Although we have insufficient data concerning this, we have experienced many more kinked endotracheal tubes (ETTs) than ETTs occluded by the cuff of the ETT. We do not believe that letting the cuff down should be the first step when a kinked ETT is far more probable than an occluded one.2 Though the pilot balloon line inserts at 18 cm on the ETT used in this case, the actual endotracheal cuff itself is far distal to this insertion. The notion that a pilot balloon line could develop an aneurysm just after the point of insertion, which could partially occlude an ETT, seems unlikely.
The Berman intubating airway is easily removed from around the ETT after intubation. The same features that make it easy to remove (the “breakaway” feature on one side and the “hinge” on the other side) also make it easy to insert. There is no need to fully open the mouth, as the teeth need only to be separated by the outside diameter of the airway. Soft tissue edema of the tongue and lips are frequently easy to overcome with the rigidity and form of the Berman airway.
When a better method is available, trying to pass a catheter of any reasonable inside diameter through an ETT with a significant kink is probably not the best use of important time to restoring patency. In addition, ventilating through a very small diameter tube can lead to quickly increasing carbon dioxide levels, which may be of concern in open cranium neurosurgical cases such as this one.
Welcome!
We have emailed you at with instructions on how to set up a new password. If you do not receive an email in the next 24 hours, or if you misplace your new password, please contact:
ASA members: Contact WK Member Services Memberservice@lww.com US and Canada: 866-489-0443 Worldwide: 301-223-2300
or
Non-member individual subscribers: Contact WK Customer Service Customerservice@lww.com US and Canada: 1-800-638-3030 Worldwide: 301-223-2300
...but there is no email account associated with it. To get started with Anesthesiology, we'll need to send you an email. To add an email address to your ASA account please contact us:
Forgot your password? Enter your username and email address. We'll send you a link to reset your password.
Forgot your username? Enter your email address. We'll send you your username identified by your email account.