A jet-stylet endotracheal catheter for difficult airway management

Abstract

In providing anesthesia for head and neck surgery, the management of patients with severely compromised upper airways is common. In most instances this situation is secondary to edema and/or tumor of the tongue, pharynx, or glottis. In some cases severe anatomic distortion has occurred due to prior resection of masses involving these structures. To assure the safety and ease of management of patients with these and other anomalies, we have developed a 'jet-stylet' endotracheal catheter. The jet-stylet endotracheal catheter has been used clinically at our hospital for approximately 2 yr. All attempts at intubation over the catheter have been successful. It has been used for intubation or reintubation of the trachea in 59 patients without complication. In situations where the catheter has been used for insufflation of jet ventilation, it has functioned adequately. In a series of six patients, jet ventilated via the catheter, normocarbia was maintained and oxygenation was adequate as determined by analysis of arterial blood gases.