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Anaesth Intensive Care · Nov 2011
ReviewLaryngeal mask airway for airway control during percutaneous dilatational tracheostomy.
- T Pratt and J Bromilow.
- Ronald Fisher Department of Anaesthesia, Poole General Hospital, Poole, Dorset, UK. tompratt@doctors.org.uk
- Anaesth Intensive Care. 2011 Nov 1;39(6):1009-13.
AbstractPercutaneous dilatational tracheostomy is a common bedside procedure in critical care for patients requiring prolonged mechanical ventilation. The traditional technique requires withdrawal of the endotracheal tube to a proximal position to facilitate tracheostomy insertion, but this carries the risk of inadvertent extubation and does not prevent cuff rupture. Use of a supraglottic airway such as the laryngeal mask airway may avoid these risks and could provide a safe alternative to the endotracheal tube. We present an appraisal of the literature to date. We found reasonable evidence to show improved ventilation and bronchoscopic visualisation with the laryngeal mask airway, but this has not been translated into improved outcome. There is currently insufficient evidence to draw conclusions about the safety of the laryngeal mask airway during percutaneous dilatational tracheostomy.
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