Percutaneous transtracheal catheter ventilation (PTCV) in complete airway obstruction--a canine model

Percutaneous transtracheal catheter ventilation (PTCV) may be used as an alternative airway when contraindications to endotracheal intubation exist. A canine model tested the efficacy of low-flow oxygen delivery, coupled with commonly available intravenous catheters, for PTCV in a large animal model. Previous studies at this institution demonstrated the feasibility of this technique in a small animal model (feline). Eighteen mongrel dogs were anesthetized, intubated, and ventilated for 30 min with a volume ventilator. The endotracheal tube was then removed, the trachea cross-clamped, and PTCV was instituted and continued for 60 minutes. Arterial blood gas analysis was performed every 5-15 min during the experimental period. Oxygen flow rates of 3, 5, and 7 L/min were paired with catheter sizes of 10 and 12 gauge (g) creating six experimental groups (three animals in each group). Data demonstrate that PTCV provided adequate oxygenation (pO2 greater than 450 mm Hg) and ventilation (pCO2 less than 85 mm Hg) with flow rates of 5 and 7 L/min with both catheter sizes. Satisfactory oxygenation (pO2 greater than 250 mm Hg) could be obtained with the 3 L/min flow rate with both catheter sizes, but ventilation was inadequate (PCO2 greater than 200 mm Hg). Using readily available materials and low-flow oxygen rates this PTCV technique was shown to be safe and effective in oxygenating and ventilating this canine model with complete airway obstruction.