[Comparison of execution time and tissue damage by using four ready-to-use percutaneous emergency airway access...

Objective: Assessment of execution time and tissue damage during providing percutaneous airway access using four ready-to-use sets: Quicktrach I (Q1) and II (Q2), Portex Cricothyroidothomy Kit (PCK) and Surgicric I (SC).

Material and methods:Prospective laboratory test. Each of 54 participants carried out 1 puncture on porcine larynx preparation for each of 4 sets, which resulted in a total of 216 trials. Efficacy was defined as placing a cannula in the tracheal lumen ensuring adequate ventilation. Safety was assessed based on the size and type of laryngeal damage, improper placement of the cannula, perforation of the esophagus and extensive destruction of surrounding tissues.

Results: The percentage of effective procedures for respective sets was: PCK - 94.4%; Q1 - 100.0%; Q2 - 96.3%; SC - 96.3%. Differences were not statistically significant. There were significant differences in duration of the procedure: PCK - 59.20 s (20.0-188.0 s, SD ± 35.25), Q1 - 21.76 s (6.0-61.0 s; SD ± 10.62), Q2 - 28.36 s (5.0-71.0 s, SD ± 14.86), SC - 48.71 s (29.0-9.0 s, SD ± 15.07). The size of the lesions of anterior and posterior walls of the larynx and trachea were significantly different. The mean (SD) lesions of the anterior laryngeal wall for respective sets were: PCK - 11.18 mm ± 5.11; Q1 - 6.59 mm ± 2.22; Q2 - 7.71 mm ± 1.87; SC - 19.85 mm ± 5.72, and for the posterior wall of the trachea: PCK - 8.29 ± ± 8.43; Q1 - 0.44 mm ± 1.22; Q2 - 0.92 mm ± 3.79; SC - 0.08 mm ± 0.27. Percentage of additional damages for respective sets: PCK - 18.5%, Q1 - no damages; Q2 - 5.6% and SC - 3.7%.

Conclusions: There were no differences in the efficacy of particular sets. Significant differences were demonstrated for the duration and safety of the procedure. The average time as well as the size of posterior wall damage and the amount of additional damage was the highest for PCK and the lowest in case of Q1.