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Dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients
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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458602/ https://www.ncbi.nlm.nih.gov/pubmed/30971211 http://dx.doi.org/10.1186/s12871-019-0723-9 |
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author | Roten, Fredy-Michel Steffen, Richard Kleine-Brueggeney, Maren Greif, Robert Wipfli, Marius Arnold, Andreas Fischer, Henrik Theiler, Lorenz |
author_facet | Roten, Fredy-Michel Steffen, Richard Kleine-Brueggeney, Maren Greif, Robert Wipfli, Marius Arnold, Andreas Fischer, Henrik Theiler, Lorenz |
author_sort | Roten, Fredy-Michel |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6458602 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-64586022019-04-19 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 BMC Anesthesiol Research Article 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. BioMed Central 2019-04-11 /pmc/articles/PMC6458602/ /pubmed/30971211 http://dx.doi.org/10.1186/s12871-019-0723-9 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Roten, Fredy-Michel Steffen, Richard Kleine-Brueggeney, Maren Greif, Robert Wipfli, Marius Arnold, Andreas Fischer, Henrik Theiler, Lorenz Dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients |
title | Dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients |
title_full | Dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients |
title_fullStr | Dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients |
title_full_unstemmed | Dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients |
title_short | Dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients |
title_sort | dislocation rates of postoperative airway exchange catheters - a prospective case series of 200 patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458602/ https://www.ncbi.nlm.nih.gov/pubmed/30971211 http://dx.doi.org/10.1186/s12871-019-0723-9 |
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