Combitube

Combitube™ is a tube with double light allowing the ventilation while protecting the higher air routes from the risk of inhalation of the gastric contents regurgity. It was conceived by Frass and Frenzer at the end of the years 1980 starting from the concept of the obturator œsophagien.

Description

Extract of:

Conferences of actualization 1999, p. 267-278. © 1999 Elsevier, Paris, and SFAR
Novel methods for difficult intubation, A.M. Cross-country race, Department of anesthesia-reanimation IV, hospital Pellegrin-Children, 33076 Bordeaux cedex, France

It is composed in the proximale part of two tubes distinct coupled and separated by a wall in the distal half. The first tube (n° 1) known as tube “œsophagien” or “pharyngé” is closed at its distal end. Eight oval perforations, located on the former and posterior walls, are distributed on the final part of the tube located between the two small baloons. These perforations allow ventilation if positioning is œsophagien.

It is recommended to make the test of ventilation on the tube “pharyngé” to avoid gastric blowing. If Combitube™ is in the esophagus, ventilation is done via the pharynx, the nasopharynx and the esophagus being blocked by the two small baloons. The sounding of the pulmonary fields confirms the ventilation which is continued on the way n° 1. The gastric contents are aspired or trapped by the way n° 2. If the pulmonary sounding is negative and the noise insufflatoire perceived in the hollow epigastric, ventilation is done by the tube n° 2, Combitube™ being in the trachea. After confirmation of the good position by the sounding, the pharyngé small baloon can be deflated. In this case, Combitube™ is fixed on the face of the patient at the manner of a probe of standard intubation. The pharyngé small baloon is maintained inflated to stabilize it and prevent its expulsion or displacement.

References

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