Cargando…

Comparing methods to secure a tracheal tube placed via a surgical cricothyroidotomy: a randomised controlled study in cadavers

OBJECTIVE: In the ‘can’t intubate can’t oxygenate’ scenario, techniques to achieve front of neck access to the airway have been described in the literature but there is a lack of guidance on the optimal method for securing the tracheal tube (TT) placed during this procedure. The aim of this study wa...

Descripción completa

Detalles Bibliográficos
Autores principales: Groombridge, Christopher J, Maini, Amit, Mathew, Joseph, Kim, Yesul, Fitzgerald, Mark, Smit, De Villiers, O’Reilly, Gerard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317275/
https://www.ncbi.nlm.nih.gov/pubmed/34321049
http://dx.doi.org/10.1186/s13049-021-00925-y
_version_ 1783730040035344384
author Groombridge, Christopher J
Maini, Amit
Mathew, Joseph
Kim, Yesul
Fitzgerald, Mark
Smit, De Villiers
O’Reilly, Gerard
author_facet Groombridge, Christopher J
Maini, Amit
Mathew, Joseph
Kim, Yesul
Fitzgerald, Mark
Smit, De Villiers
O’Reilly, Gerard
author_sort Groombridge, Christopher J
collection PubMed
description OBJECTIVE: In the ‘can’t intubate can’t oxygenate’ scenario, techniques to achieve front of neck access to the airway have been described in the literature but there is a lack of guidance on the optimal method for securing the tracheal tube (TT) placed during this procedure. The aim of this study was to compare three different methods of securing a TT to prevent extubation following a surgical cricothyroidotomy. METHODS: A randomised controlled trial was undertaken. The population studied were emergency physicians (EPs) attending a cadaveric airway course. The intervention was securing a TT placed via a surgical cricothyroidotomy by suture. The comparison was securing the TT using fabric tape with two different tying techniques. The primary outcome was the force required to extubate the trachea. The trial was registered with ANZCTR.org.au (ACTRN12621000320853). RESULTS: 17 emergency physicians completed intubations using all three of the securing methods on 12 cadavers for a total of 51 experiments. The mean extubation force was 6.54 KG (95 % CI 5.54–7.55) in the suture group compared with 2.28 KG (95 % CI 1.91–2.64) in the ‘Wilko tie’ group and 2.12 KG (95 % CI 1.63–2.60) in the ‘Lark’s foot tie’ group; The mean difference between the suture and fabric tie techniques was significant (p < 0.001). CONCLUSIONS: Following a surgical cricothyroidotomy in cadavers, EPs were able to effectively secure a TT using a suture technique, and this method was superior to tying the TT using fabric tape.
format Online
Article
Text
id pubmed-8317275
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-83172752021-07-28 Comparing methods to secure a tracheal tube placed via a surgical cricothyroidotomy: a randomised controlled study in cadavers Groombridge, Christopher J Maini, Amit Mathew, Joseph Kim, Yesul Fitzgerald, Mark Smit, De Villiers O’Reilly, Gerard Scand J Trauma Resusc Emerg Med Original Research OBJECTIVE: In the ‘can’t intubate can’t oxygenate’ scenario, techniques to achieve front of neck access to the airway have been described in the literature but there is a lack of guidance on the optimal method for securing the tracheal tube (TT) placed during this procedure. The aim of this study was to compare three different methods of securing a TT to prevent extubation following a surgical cricothyroidotomy. METHODS: A randomised controlled trial was undertaken. The population studied were emergency physicians (EPs) attending a cadaveric airway course. The intervention was securing a TT placed via a surgical cricothyroidotomy by suture. The comparison was securing the TT using fabric tape with two different tying techniques. The primary outcome was the force required to extubate the trachea. The trial was registered with ANZCTR.org.au (ACTRN12621000320853). RESULTS: 17 emergency physicians completed intubations using all three of the securing methods on 12 cadavers for a total of 51 experiments. The mean extubation force was 6.54 KG (95 % CI 5.54–7.55) in the suture group compared with 2.28 KG (95 % CI 1.91–2.64) in the ‘Wilko tie’ group and 2.12 KG (95 % CI 1.63–2.60) in the ‘Lark’s foot tie’ group; The mean difference between the suture and fabric tie techniques was significant (p < 0.001). CONCLUSIONS: Following a surgical cricothyroidotomy in cadavers, EPs were able to effectively secure a TT using a suture technique, and this method was superior to tying the TT using fabric tape. BioMed Central 2021-07-28 /pmc/articles/PMC8317275/ /pubmed/34321049 http://dx.doi.org/10.1186/s13049-021-00925-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Original Research
Groombridge, Christopher J
Maini, Amit
Mathew, Joseph
Kim, Yesul
Fitzgerald, Mark
Smit, De Villiers
O’Reilly, Gerard
Comparing methods to secure a tracheal tube placed via a surgical cricothyroidotomy: a randomised controlled study in cadavers
title Comparing methods to secure a tracheal tube placed via a surgical cricothyroidotomy: a randomised controlled study in cadavers
title_full Comparing methods to secure a tracheal tube placed via a surgical cricothyroidotomy: a randomised controlled study in cadavers
title_fullStr Comparing methods to secure a tracheal tube placed via a surgical cricothyroidotomy: a randomised controlled study in cadavers
title_full_unstemmed Comparing methods to secure a tracheal tube placed via a surgical cricothyroidotomy: a randomised controlled study in cadavers
title_short Comparing methods to secure a tracheal tube placed via a surgical cricothyroidotomy: a randomised controlled study in cadavers
title_sort comparing methods to secure a tracheal tube placed via a surgical cricothyroidotomy: a randomised controlled study in cadavers
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317275/
https://www.ncbi.nlm.nih.gov/pubmed/34321049
http://dx.doi.org/10.1186/s13049-021-00925-y
work_keys_str_mv AT groombridgechristopherj comparingmethodstosecureatrachealtubeplacedviaasurgicalcricothyroidotomyarandomisedcontrolledstudyincadavers
AT mainiamit comparingmethodstosecureatrachealtubeplacedviaasurgicalcricothyroidotomyarandomisedcontrolledstudyincadavers
AT mathewjoseph comparingmethodstosecureatrachealtubeplacedviaasurgicalcricothyroidotomyarandomisedcontrolledstudyincadavers
AT kimyesul comparingmethodstosecureatrachealtubeplacedviaasurgicalcricothyroidotomyarandomisedcontrolledstudyincadavers
AT fitzgeraldmark comparingmethodstosecureatrachealtubeplacedviaasurgicalcricothyroidotomyarandomisedcontrolledstudyincadavers
AT smitdevilliers comparingmethodstosecureatrachealtubeplacedviaasurgicalcricothyroidotomyarandomisedcontrolledstudyincadavers
AT oreillygerard comparingmethodstosecureatrachealtubeplacedviaasurgicalcricothyroidotomyarandomisedcontrolledstudyincadavers