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Updated: Aug 16, 2026

The Rigid Tube as an Alternative in Controlling the Problematic Airway
Published on: June 6, 2020
Prophylactic percutaneous transtracheal catheterisation in the management of patients with anticipated difficult
H J Gerig1, T Schnider, T Heidegger
1Department of Anaesthesiology, St Gallen Cantonal Hospital, Rorschacherstrasse 95, CH-9007 St Gallen, Switzerland. hansjoerg.gerig@kssg.ch
Abstract:
Primary tracheostomy under local anaesthesia is indicated in the management of an anticipated difficult airway in patients in whom less invasive procedures are expected to fail or have already failed. However, primary tracheostomy is a relatively complex procedure and places not inconsiderable stress on the patient. In a prospective study in our hospital over a period of 22 months, we were able to avoid primary tracheostomy in 11 patients with very difficult airways. All 11 patients were managed with prophylactically inserted transtracheal catheters and jet ventilation of the lungs. This ensured an adequate oxygen supply during tracheal intubation, and made overall patient management much easier. This method has established itself as a standard procedure in our hospital.
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