Current status of the Combitube™: a review of the literature - 01/09/11

Doi : 10.1016/S0952-8180(02)00356-2

Felice Agro, MD ⁎, ^a,^{Professor and Chairman of Anesthesiology, University School of Medicine Campus Bio-Medico, Rome, Italy} , Michael Frass, MD ^b,^{†
Professor of Medicine, University of Vienna, Vienna, Austria}, Jonathan L Benumof, MD ^c,^{‡
Professor of Anesthesiology, University of California San Diego Medical Center, San Diego, CA}, Peter Krafft, MD, PhD ^d,^{§
Professor of Anesthesiology, University of Vienna, Vienna, Austria}
^a Department of Anesthesiology, University School of Medicine Campus Bio-Medico, Rome, Italy
^b Department of Internal Medicine I, University of Vienna, Vienna, Austria
^c Department of Anesthesiology, University of California San Diego Medical Center, San Diego, CA, USA
^d Department of Anesthesiology and Intensive Care Medicine, University of Vienna, Vienna, Austria

^*Address correspondence to Professor Agro at the Department of Anesthesiology, University School of Medicine Campus Bio-Medico—Rome, Via Longoni, 69/83-00155 Rome, Italy

Abstract

The Combitube™ (Tyco-Healthcare-Kendall-Sheridan, Mansfield, MA) is an easily inserted and highly efficacious device to be used as an alternative airway whenever conventional ventilation fails. The Combitube allows ventilation and oxygenation whether the device locates in the esophagus (very common) or the trachea (rare). In this report, we review studies that suggest the Combitube is a valuable and effective airway in the emergency and prehospital settings, in cardiopulmonary resuscitation, in elective surgery, and in critically ill patients in the intensive care unit. Also reviewed are studies that demonstrate the superiority of the Combitube over other supraglottic ventilatory devices in resuscitation with respect to success rates with insertion and ventilation. Contrary to the Laryngeal Mask Airway™, the Combitube may help in patients with limited mouth opening. The Combitube may be of special benefit in patients with massive bleeding or regurgitation, and it minimizes the risk of aspiration.

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Keywords : Airway, difficult, “cannot ventilate-cannot intubate”, cardiopulmonary resuscitation, elective surgery, equipment and supplies: Combitube^®, intubation, intratracheal: difficult, ventilation, emergency