Airway fires: reducing the risk during laser surgery

Area of Science:

• Anesthesiology and Surgical Safety
• Medical Device Evaluation
• Laser Surgery Technology

Background:

• Patient safety during laser surgery necessitates fire-resistant ventilation methods.
• Standard endotracheal tubes (ETTs) pose a fire risk when exposed to surgical laser energy.
• Laser-resistant ETTs (LRETTs) and protective wraps are potential solutions.

Purpose of the Study:

• To evaluate the fire resistance and clinical suitability of marketed LRETTs.
• To assess the efficacy of wraps in protecting standard ETTs from laser energy.
• To provide data for informed clinical decision-making regarding laser surgery safety.

Main Methods:

• Five LRETTs from different manufacturers were tested against CO2, ND:YAG, and KTP laser energy.
• Four wraps for standard ETTs were evaluated for their protective capabilities.
• Performance was rated based on resistance to burning and protection under simulated surgical conditions.

Main Results:

• The Baxter Norton LRETT provided the best overall protection against all tested laser types, rated Acceptable.
• Bivona and Mallinckrodt LRETTs were rated Acceptable for specific laser types (CO2, KTP) under limited conditions.
• The Merocel wrap demonstrated Acceptable protection against CO2 and KTP laser energy; non-medical tapes were conditionally acceptable but not recommended.

Conclusions:

• LRETTs, particularly the Baxter Norton model, and the Merocel wrap offer viable safety solutions for laser surgery ventilation.
• Non-medical tapes are not recommended due to lack of FDA review and user liability.
• Clinicians should carefully consider product evaluations to ensure optimal patient safety during laser procedures.