Evaluation of the oesophageal-tracheal double-lumen tube (Combitube) during general anaesthesia.
OBJECTIVE
Evaluation of safety and effectiveness of the Combitube during general anaesthesia.


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 mmHg. 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.


CONCLUSIONS
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.
Department of Internal Medicine I, Intensive Care Unit, University of Vienna, Vienna, Austria.
Werner
W
Rabitsch
Peter
P
Krafft
Franz X
FX
Lackner
Reinhard
R
Frenzer
Roland
R
Hofbauer
Camillo
C
Sherif
Michael
M
Frass
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000399:Air Pressure; D000768:Anesthesia, General / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D004869:Equipment Safety; D004947:Esophagus; D005260:Female; D006801:Humans; D007440:Intubation / Q000295:instrumentation*; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000295:instrumentation; D012123:Pulmonary Ventilation / Q000502:physiology; D013990:Tidal Volume / Q000502:physiology