Comparison of laryngeal mask airway and endotracheal tube using percutaneous dilatational tracheostomy

Yıl 2023, Cilt: 28 Sayı: 2, 164 - 169, 23.05.2023

Nezir Yılmaz , Mehmet Duran , Fikret Özerdem

https://doi.org/10.21673/anadoluklin.1194680

Öz

Aim: The study’s objective was to determine whether laryngeal mask airway (LMA) use in percutaneous tracheostomy applications is superior compared to classic endotracheal tube (ETT) use.

Methods: The study comprised patients who had percutaneous tracheostomy at Adıyaman Training and Research Hospital between 2013 and 2018. The patients were separated into two groups those who used ETT for airway management (group E) and those who used LMA instead of ETT (group L) during PT application. 4 patients were excluded from the study due to the lack of data from the 170 patient files obtained. The diagnosis for intensive care unit admission, age, gender, length of hospital stay, length of the procedure, number of attempts, complications, and mortality were compared between the two groups.

Results: Of the 166 patients involved in the study, 76 were female and 90 were male. All patients underwent successful tracheostomy procedures, but 20 patients had minimal bleeding, and 21 patients had a second attempt. The duration of the tracheostomy procedure was found to be significantly shorter in group L (p<0.05). In comparison to group E, group L had a significantly longer hospital stay (p<0.05).

Conclusion: It was considered that the use of LMA in percutaneous dilatational tracheostomy applications reduces the duration of the surgery. However, there is no significant difference between the use of ETT and LMA in terms of procedural success and complication rates.
Keywords: Airway management, laryngeal mask airway, tracheostomy

Anahtar Kelimeler

Airway management, laryngeal mask airway, tracheostomy

Destekleyen Kurum

no

Proje Numarası

no

Perkütan dilatasyonel trakeostomi uygulamasında laringeal maske havayolu ile endotrakeal tüp kullanımının karşılaştırılması

Öz

Amaç: Perkütan trakeostomi uygulamalarında laringeal maske kullanımının klasik endotrakeal tüp kullanımına üstünlüğünün olup olmadığının incelenmesi amaçlandı.

Yöntemler: 2013-2018 yılları arasında Adıyaman Eğitim ve Araştırma Hastanesi’nde perkütan trakeostomi uygulanmış olan hastalar çalışmaya dahil edildi. Hastalar PT uygulaması sırasında havayolu yönetiminde ETT kullanılanlar (grup E) ve ETT yerine LMA kullanılanlar (grup L)olmak üzere iki gruba ayrıldı. Ulaşılan 170 hasta dosyasından 4 hasta eksik bilgiler nedeni ile çalışma dışı bırakıldı. Hastaların yoğun bakıma yatış tanıları, yaş, cinsiyet, hastanede yatış süresi,işlem süresi, deneme sayısı, komplikasyonlar ve mortalite durumu kaydedilerek her iki grup arasında kıyaslandı.

Bulgular: Çalışmaya dahil edilen 166 hastanın 76’sı kadın ve 90’ı erkek olarak tespit edildi. Tüm hastalarda trakeostomi başarılı olup 20 hastada minör kanama ve 21 hastada 2. deneme tespit edildi. Trakeostomi işlem süresi grup L’de anlamlı düzeyde daha kısa olarak bulundu (p < 0.05). Grup L’de hastanede yatış süresi grup E’den anlamlı (p < 0.05) olarak daha yüksekti.

Sonuç: Perkütan dilatasyonel trakeostomi uygulamalarında LMA kullanımının işlem süresini kısalttığı ancak işlem başarısı ve komplikasyon oranları açısından ETT kullanımı ile anlamlı bir farklılığı olmadığını düşünmekteyiz.

Anahtar Kelimeler

Havayolu yönetimi, laringeal maske havayolu, trakeostomi

Proje Numarası

no

Kaynakça

• Szmuk P, Ezri T, Evron S, Roth Y, Katz J. A brief history of tracheostomy and tracheal intubation, from the Bronze Age to the Space Age. Intensive Care Med. 2008;34(2):222-8.
• Freeman BD, Isabella K, Cobb JP, et al. A prospective, randomized study comparing percutaneous with surgical tracheostomy in critically ill patients. Crit Care Med. 2001;29(5):926-30.
• Yu M. Tracheostomy patients on the ward: multiple benefits from a multidisciplinary team? Crit Care. 2010;14(1):109.
• Ambesh 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. J Postgrad Med. 2002;48(1):11-15.
• Emigh B, Zaunbrecher RD, Trust MD, Teixeira PG, Brown CV, Aydelotte JD. A safer placement technique for percutaneous dilatational tracheostomy. Am J Surg. 2021;222(5):913-5.
• Strametz R, Bergold MN, Weberschock T. Laryngeal mask airway versus endotracheal tube for percutaneous dilatational tracheostomy in critically ill adults. Cochrane Database Syst Rev. 2018;11(11):CD009901.
• Linstedt U, Zenz M, Krull K, Häger D, Prengel AW. Laryngeal mask airway or endotracheal tube for percutaneous dilatational tracheostomy: A comparison of visibility of intratracheal structures. Anesth Analg. 2010;110(4):1076–82.
• Al-Ansari MA, Hijazi MH. Clinical review: percutaneous dilatational tracheostomy. Crit Care. 2006;10(1):202.
• Arora R, Kumar S, Sachan S. GuideWire migrating into murphy’s eye of endotracheal tube: An unusual complication of percutaneous dilational tracheostomy. Anesth Essays Res. 2017;11(4):1091.
• Sonti R, Sanley M, Vinayak A. Using a laryngeal mask airway during percutaneous dilatational tracheostomy is safe and obviates the need for paralytics. J Bronchology Interv Pulmonol. 2019;26(3):179–83.
• Silvester W, Goldsmith D, Uchino S, et al. Percutaneous versus surgical tracheostomy: A randomized controlled study with long-term follow-up. Crit Care Med. 2006;34(8):2145–52.
• Kaiser E, Cantais E, Goutorbe P, Salinier L, Palmier B. Prospective randomized comparison of progressive dilational vs forceps dilational percutaneous tracheostomy. Anaesth Intensive Care. 2006;34(1):51-4.
• Atlas A, Altay N. Our Percutaneous Tracheostomy Experience in Our Intensive Care Unit: A Retrospective Analysis. Journal of Harran University Medical Faculty. 2021;18:104–8.
• Dosemeci L, Yilmaz M, Gürpinar F, Ramazanoglu A. The use of the laryngeal mask airway as an alternative to the endotracheal tube during percutaneous dilatational tracheostomy. Intensive Care Med. 2002;28(1):63–7.
• Yasar E, Donmez E, Demirbilek G. Use of proseal laringeal mask airway under bronchoscopy guidance during percutaneous dilatational tracheostomy. JARSS. 2022;30(1):9–15.
• Kaya FN, Girgin NK, Yavaşcaoğlu B, Caoglu FK, Korfali G. Perkütan trakeostomi sirasmda ’Larengeal Maske’ ve ’Kafli Orofarengeal Havayolu’ kullanimi. Ulus Travma Acil Cerrahi Derg. 2006;12(4):282–7.