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Evaluation of the oesophageal-tracheal double-lumen tube (Combitube) during general anaesthesia

Evaluation des ösophago-trachealen Doppellumen-Tubus (Combitube) in Allgemeinnarkose

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Zusammenfassung

Fragestellung

Evaluation auf Sicherheit und Verlässlichkeit und Wirksamkeit des Combitube (Tyco Healthcare, Brunn am Gebirge, Österreich) während Allgemeinanästhesie.

Patienten und Methoden

250 Patienten, die eine Allgemeinanästhesie erhielten, wurden in die Studie eingeschlossen. Die verschiedenen Operationstypen, die Dauer der Operationen, Leichtigkeit der Einführung, und potentielle Komplikationen wurden registriert. Zudem wurden maximale Beatmungsdrücke und das Ausmaß der Leckage ermittelt.

Ergebnisse

Die Dauer der Operationen variierte zwischen 20 und 410 Minuten. Mehr als 96% der blinden Combitube Einführungen waren beim ersten Versuch nach einer durchschnittlichen Zeit von 18±5 Sekunden (12 bis 24 Sekunden) erfolgreich. Bei 99% der Patienten war es möglich, eine adäquate Oxygenation und Ventilation aufrecht zu erhalten. Alle Patienten waren während der Gesamtdauer der Operationen hämodynamisch stabil, mit einer pulsoximetrisch gemessenenen Sauerstoffsättigung von 97±2%. Der end-tidal gemessene Kohlendioxid-Partialdruck war 38±6 mm Hg. Die Leckage betrug auch bei Beatmungsdrücken von bis zu 40 cm H2O nicht mehr als 5%. Bei 18 Patienten (7,2%) fanden sich oberflächliche Schleimhaut-Lazerationen ohne anhaltende Folgeschäden. Es wurden keine schwerwiegenden Komplikationen während der Studie beobachtet.

Zusammenfassung

Die Beatmung via Combitube während Allgemeinanästhesie erscheint sicher und effektiv. Der Einsatz des Combitube sollte jedoch in Hinblick auf einen zukünftigen Notfalleinsatz bei elektiven Eingriffen trainiert werden.

Summary

Objectives

Evaluation of safety and effectiveness of the Combitube during general anaesthesia.

Patients and methods

250 patients undergoing general anaesthesia were enrolled in the study. The respective types and duration of surgery, ease of insertion of the Combitube, and potential complications were recorded. Maximum ventilatory pressures and leak fraction were also evaluated in this study.

Results

Duration of surgery varied between 20 and 410 min. More than 96% of the blind Combitube insertions were successful at the first attempt, with a mean time of less than 18±5 seconds (range 12–24 seconds). In 99% of patients the Combitube worked well, and adequate oxygenation and ventilation was possible. All patients were haemodynamically stable during the entire duration of surgery. In all patients, pulse oximetry showed an oxygen saturation of 97±2% and an end-tidal carbon dioxide of 38±6 mm Hg. Leak fraction, calculated as a fraction of the inspired volume, did not increase to more than 5% up to a ventilation pressure of 40 cm H2O. Superficial laceration occurred in 18 patients (7.2%) without further sequelae. No severe injuries were observed during the study period.

Conclusion

Ventilation via the Combitube appears to be safe and effective during general anaesthesia. Practice in elective cases is a requirement for successful use in an emergency situation.

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Authors and Affiliations

  1. Department of Internal Medicine I, Intensive Care Unit, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria

    Werner Rabitsch, Reinhard Frenzer, Roland Hofbauer, Camillo Sherif & Michael Frass

  2. Department of Anaesthesiology and General Intensive Care Medicine, University of Vienna, Vienna, Austria

    Peter Krafft & Franz X. Lackner

Authors
  1. Werner Rabitsch
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  2. Peter Krafft
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  3. Franz X. Lackner
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  4. Reinhard Frenzer
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  5. Roland Hofbauer
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  6. Camillo Sherif
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  7. Michael Frass
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Corresponding author

Correspondence to Michael Frass.

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Rabitsch, W., Krafft, P., Lackner, F.X. et al. Evaluation of the oesophageal-tracheal double-lumen tube (Combitube) during general anaesthesia. Wien Klin Wochenschr 116, 90–93 (2004). https://doi.org/10.1007/BF03040702

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  • DOI: https://doi.org/10.1007/BF03040702

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