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From the Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, United Kingdom.
Address correspondence to: Dr. Jerry P. Nolan, Consultant in Anaesthesia and Intensive Care Medicine, Royal United Hospital, Combe Park Bath BA1 3NG, United Kingdom. Phone: +44-1225-825057; Fax: +44-1225-825061; E-mail: jerry.nolan{at}ruh-bath.swest.nhs.uk
Purpose: To study the feasibility of using the Pro-Seal laryngeal mask airway (LMA) for airway maintenance during bronchoscopic guided percutaneous tracheostomy.
Methods: Observational study of 23 patients in an 11-bed general intensive care unit. The patient’s tracheal tube was exchanged for a Pro-Seal LMA before undertaking percutaneous tracheostomy.
Results: Inspiratory pressure and tidal volumes achieved during the procedure were recorded. The median peak inspiratory pressure was 25 (standard deviation 4.2) cm H2O. There was no loss of tidal volume in 11 patients, a loss of less than 100 mL•breath-1 in 11, and loss of more than 100 mL in one. A Pro-Seal LMA successfully maintained the airway and allowed adequate ventilation during percutaneous tracheostomy in all 23 patients. In all patients bronchoscopy through the Pro-Seal LMA provided a clear view of the cords and trachea and there was no laryngeal or tracheal soiling at any stage of the procedure.
Conclusion: The Pro-Seal LMA provides a reliable airway and allows effective ventilation during percutaneous tracheostomy. The passage of a fibrescope through the Pro-Seal LMA and glottis is easy and provides a clear view of the upper trachea.
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