Laryngeal mask airway vs endotracheal tube to facilitate bedside percutaneous tracheostomy in critically ill patients: a prospective comparative study.

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dc.contributor.authorAmbesh, S Pen_US
dc.contributor.authorSinha, P Ken_US
dc.contributor.authorTripathi, Men_US
dc.contributor.authorMatreja, Pen_US
dc.date.accessioned2002-01-26en_US
dc.date.accessioned2009-06-02T11:58:50Z
dc.date.available2002-01-26en_US
dc.date.available2009-06-02T11:58:50Z
dc.date.issued2002-01-26en_US
dc.description.abstractBACKGROUND: Inadvertent puncture of endotracheal tube (ETT) cuff and accidental tracheal extubation are the potential life threatening complications during percutaneous dilatational tracheostomy (PDT). As an alternative to ETT, the laryngeal mask airway (LMA) has been used sporadically but no large study is available on its use. AIMS: To study the use of LMA during PDT on controlled ventilation in critically sick patients and compare its advantages and disadvantages in relation to ETT. SETTINGS AND DESIGN: This prospective, randomised, comparative study was conducted in intensive care unit of a super-speciality, tertiary care hospital. METHODS AND MATERIAL: The bedside PDT was performed in 60 critically ill patients using Ciaglia's kit. The patients received controlled ventilation of lungs either through ETT or LMA. The feasibility of the procedure and complications were compared in two groups. RESULTS: In LMA group, 33% of patients suffered with potentially catastrophic complications, e.g., loss of airway, inadequate ventilation of lungs leading to significant hypoxia, gastric distension and regurgitation. In ETT group there were 6.6% incidence of ETT impalement, 6.6% cuff puncture and 3.3% accidental tracheal extubation. Despite the technical difficulties (cuff puncture, etc.) the ETT technique was basically safe, whereas despite of the theoretical advantages the LMA technique rendered some patients at considerable risks of hypoxia and gastric regurgitation-aspiration. CONCLUSION: The LMA does not provide safe patent airway to facilitate bedside PDT in critically sick population on controlled ventilation. The ETT is safer for controlled ventilation and should be continued to secure the airway for this purpose until a better alternative is available.en_US
dc.description.affiliationDepartment of Anaesthesiology and Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow - 226 014, India. ambeshsp@hotmail.comen_US
dc.identifier.citationAmbesh SP, Sinha PK, Tripathi M, Matreja P. Laryngeal mask airway vs endotracheal tube to facilitate bedside percutaneous tracheostomy in critically ill patients: a prospective comparative study. Journal of Postgraduate Medicine. 2002 Jan-Mar; 48(1): 11-5en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/116591
dc.language.isoengen_US
dc.source.urihttps://www.jpgmonline.comen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshCritical Illnessen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIntensive Care Unitsen_US
dc.subject.meshIntubation, Intratracheal --instrumentationen_US
dc.subject.meshLaryngeal Masksen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshTrachea --injuriesen_US
dc.subject.meshTracheostomy --adverse effectsen_US
dc.titleLaryngeal mask airway vs endotracheal tube to facilitate bedside percutaneous tracheostomy in critically ill patients: a prospective comparative study.en_US
dc.typeClinical Trialen_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
dc.typeRandomized Controlled Trialen_US
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