title: The routine use of pediatric airway exchange catheter after extubation of adult patients who have undergone maxillofacial or major neck surgery: a clinical observational study.
abstract: BACKGROUND
  We conducted the present study to determine the usefulness of routinely inserting a pediatric airway exchange catheter (PAEC) before tracheal extubation of adult patients who had undergone maxillofacial or major neck surgery and have risk factors for difficult reintubation.
  
  
  METHODS
  A prospective, observational and clinical study was performed in the 25-bed general intensive care unit of a university hospital. Thirty-six adult patients who underwent maxillofacial or major neck surgery and had risk factors for difficult reintubation were extubated after insertion of the PAEC.
  
  
  RESULTS
  Four of 36 (11.1%) patients required emergency reintubation after 2, 4, 6 and 18 hours after tracheal extubation, respectively. Reintubation of these patients, which was thought to be nearly impossible by direct laryngoscopy, was easily achieved over the PAEC.
  
  
  CONCLUSIONS
  The PAEC can be a life-saving device during reintubation of patients with risk factors for difficult reintubation such as laryngeo-pharyngeal oedema due to surgical manipulation or airway obstruction resulting from haematoma and anatomic changes. We therefore suggest the routine use of the PAEC in patients undergoing major maxillofacial or major neck surgery.
authors.affiliation: Department of Anesthesiology and ICU, Akdeniz University Hospital, Antalya, Turkey. leventege@yahoo.com
authors.forename: Levent
authors.initials: L
authors.lastname: Dosemeci
authors.forename: Murat
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Arif
authors.initials: A
authors.lastname: Yegin
authors.forename: Melike
authors.initials: M
authors.lastname: Cengiz
authors.forename: Atilla
authors.initials: A
authors.lastname: Ramazanoglu
mesh_terms: D000328:Adult; D000368:Aged; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D003422:Critical Care / Q000379:methods; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods; D012307:Risk Factors; D015300:Ventilator Weaning / Q000009:adverse effects*