The airway exchange catheter can be used both to ventilate the lungs and to act as a guide for reintubation in patients of all ages who have a tenuous airway. We report the case of a 2-year-old boy with an anatomically challenging airway in whom both an airway exchange catheter and a rigid bronchoscope were used to visualize and maintain a secure airway. We also review the literature as it pertains to the management of the difficult pediatric airway.
References
1.
LoudermilkEP, HartmannsgruberM, StoltzfusDP, LangevinPB. A prospective study of the safety of tracheal extubation using a pediatric airway exchange catheter for patients with a known difficult airway. Chest1997;111(6):1660–5.
2.
HartmannsgruberMW, LoudermilkE, StoltzfusD.Prolonged use of a Cook airway exchange catheter obviated the need for postoperative tracheostomy in an adult patient. J Clin Anesth1997;9(6):496–8.
3.
DosemeciL, YilmazM, YeginA, The routine use of pediatric airway exchange catheter after extubation of adult patients who have undergone maxillofacial or major neck surgery: A clinical observational study. Crit Care2004;8(6):R385–90.
4.
ThomasPB, ParryMG. The difficult paediatric airway: A new method of intubation using the laryngeal mask airway, Cook airway exchange catheter and tracheal intubation fibrescope. Paediatr Anaesth2001;11(5):618–21.
5.
HulmeGJ, BluesCM. Acromegaly and papillomatosis: Difficult intubation and use of the airway exchange catheter. Anaesthesia1999;54(8):787–9.
6.
Wise-FaberowskiL, NargozianC.Utility of airway exchange catheters in pediatric patients with a known difficult airway. Pediatr Crit Care Med2005;6(4):454–6.
7.
AyoubCM, LteifAM, RizkMS, Facilitation of passing the endotracheal tube over the flexible fiberoptic bronchoscope using a Cook airway exchange catheter. Anesthesiology2002;96(6):1517–18.
8.
HagbergCA. Special devices and techniques. Anesthesiol Clin North America2002;20(4):907–32.
9.
WheelerM.Management strategies for the difficult pediatric airway. Middle East J Anesthesiol2004;17(5):845–73.
10.
WheelerM, CoteCJ, TodresID. The pediatric airway. In: CotéCJ, TodresID, GoudsouzianNG, RyanJF, eds. A Practice of Anesthesia for Infants and Children. Philadelphia: W.B. Saunders; 2001:79–120.
11.
SeitzPA, GravensteinN.Endobronchial rupture from endotracheal reintubation with an endotracheal tube guide. J Clin Anesth1989;1(3):214–17.
12.
deLimaLG, BishopMJ. Lung laceration after tracheal extubation over a plastic tube changer. Anesth Analg1991;73(3):350–1.
13.
Practice guidelines for management of the difficult airway: An updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway.Anesthesiology2003;98(5):1269–77.
14.
WheelerM, DsidaRM. Fiberoptic intubation: Troubles with the “Tube”? Anesthesiology2003;99(5):1236–7.
15.
NekhendzyV, SimmondsPK. Rigid bronchoscope-assisted endotracheal intubation: Yet another use of the gum elastic bougie. Anesth Analg2004;98(2):545–7, table of contents.