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Airway control via the CobraPLA^TM during percutaneous dilatational tracheotomy in five patients

[Le contrôle des voies aériennes par le CobraPLA^TM pendant la trachéotomie dilatatrice percutanée chez cinq patients]

Felice Agrò, MD^*, Massimiliano Carassiti, MD^*, Caterina Magnani, MD^* and David Alfery, MD

^* From the Department of Anesthesia, University School of Medicine Campus Bio-Medico, Rome, Italy; and
the Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee, USA.

Address correspondence to: Prof. F. Agrò, University School of Medicine Campus Bio-Medico, Via E. Longoni 83 00155 Rome, Italy. Phone: +390622541522; Fax +390622541520; E-mail: f.agro{at}unicampus.it

Purpose: To evaluate the use of the new supraglottic airway device CobraPLA^TM (CPLA) for performing percutaneous dilatational tracheotomy (PDT) utilizing continuous fibreoptic visualization of the larynx and trachea and uninterrupted airway control.

Clinical features: The percutaneous tracheotomies were carried out in five patients (four males and one female; mean age 72 yr, mean height 164.6 cm, mean weight 74 kg) following the Griggs technique under continuous fibreoptic vision and airway control provided by the CPLA. The mean time required for removal of the ETT, positioning of the CPLA, and confirmation of adequate ventilation and cuff seal was 78 sec. The mean time for the entire PDT procedure was six minutes and 57 sec. In one patient a 7-mm tracheostomy cannula was used, and in the other four patients an 8-mm cannula was used.

The hemodynamic and respiratory variables remained stable during the entire procedure; there were no adverse events.

At no point was there any significant difficulty in placing the CPLA or in providing ventilation or oxygenation. Each procedure could be observed easily in its entirety through the FOB.

Conclusions: This technique can be considered simple and safe because it is video-assisted and ensures a continuous airway control. The CPLA offers several advantages over some other supraglottic devices when performing this surgical procedure.

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