Complications associated with the Esophageal-Tracheal Combitube

February 3, 2007

Can J Anaesth. 2007 Feb;54(2):124-128.

Complications associated with the Esophageal-Tracheal Combitube® in the

pre-hospital setting: [Complications associees avec l'utilisation du

Combitube dans la prise en charge des arrets cardio-respiratoires en

prehospitalier].

.. Vezina MC,

.. Trepanier CA,

.. PC,

.. Lessard MR.

Departement d'anesthesie-reanimation, Hopital de l'Enfant-Jesus du CHA,

1401, 18e rue, Quebec, Quebec G1J 1Z4, Canada. delalaitue@....

PURPOSE: The Esophageal-Tracheal Combitube® (Combitube) is widely used for

the management of the airway during cardiopulmonary resuscitation in the

pre-hospital setting. Although serious complications have been reported with

the Combitube, there is a paucity of data relative to the frequency and

nature of such complications. The objective of this retrospective study was

to determine the incidence and the nature of complications associated to the

Combitube in the pre-hospital setting.

METHODS: Since 1993, in the Quebec City Health Region, the basic life

support treatment algorithm for emergency medical technicians has included

the use of a Combitube as the primary airway device for management of all

patients presenting with cardiac or respiratory arrest. The database of the

emergency coordination services was searched for the period between 1993 and

2003 (2,981 patients). Only those patients who survived at least 12 hr were

included. Medical records of these patients were reviewed to identify

complications related to the use of the Combitube.

RESULTS: Two-hundred-eighty (280) patients were identified. Fifty-eight (58)

patients (20.7%, confidence interval (CI)95% = 16.0%-25.4%) presented 69

complications: aspiration pneumonitis (n = 31), pulmonary aspiration (n =

16), pneumothorax (n = 6), upper airway bleeding (n = 4), esophageal

laceration (n = 3), sc emphysema (n = 2), esophageal perforation and

mediastinitis (n = 2), tongue edema (n = 2), vocal cord injury (n = 1),

tracheal injury (n = 1), and pneumomediastinum (n = 1). Thirteen of these

complications (12 patients, 4.3%, CI(95%) = 2.0%-6.3%) were judged as most

likely resulting from trauma associated with insertion of the Combitube.

CONCLUSION: The use of the Combitube in the pre-hospital setting is

associated with a notable incidence of serious complications.

PMID: 17272251 [PubMed - as supplied by publisher]

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