The use of the laryngeal mask airway during percutaneous dilatational tracheostomy

Introduction

Percutaneous dilatational tracheostomy (PDT) is a widely used and accepted method of long-term ventilation of critically ill patients in many ICUs.

Aim

To study the use of the laryngeal mask airway (LMA) during PDT for controlled ventilation in critically sick patients and compare its complications and duration procedure in relation to the ETT.

Methods and materials

A prospective, randomized clinical trial performed in the seven-bed general ICU of a training and research hospital of the Ministry of Health. The bedside PDT was performed in 73 critically ill patients in a period of 3 years. Patients were randomly assigned to ventilation via LMA (n = 31 patients) and to ventilation via ETT (n = 42). The duration of the procedure and complications were compared in the two groups.

Results

The ETT group and the LMA group did not differ regarding age. There was no significant difference in the operating time between the two groups. We found that the incidence of complication was 26.2% in the ETT group and 25.8% in the LMA group (Table 1).

Table 1 (abstract P53)

Conclusion

The LMA is an effective and successful ventilatory device during percutaneous dilatational tracheostomy. For PDT, the LMA has an advantage over the ETT of lying remote from the operating field. The LMA does not cause the difficulties associated with the use of an ET such as cuff puncture, tube transection by the needle, and accidental extubation.