A new device for emergency percutaneous transtracheal ventilation in partial and complete airway obstruction

Several methods of percutaneous transtracheal ventilation have been described for the immediate relief of upper airway obstruction when conventional methods fail. This study was conducted to determine whether a single percutaneously placed catheter introducer (Arrow Emergency Infusion Device [EID]) could provide access adequate for percutaneous transtracheal ventilation with standard ventilatory modalities in an obstructed airway. Ten mongrel dogs were anesthetized, intubated, and monitored (for pulse, blood pressure, ECG, and arterial blood gases). The endotracheal tube was occluded. When the dogs became hypoxic and hypercarbic, the Arrow EIDs were inserted transtracheally and the dogs were ventilated with either a Bear 1 Adult Ventilator or a Mapleson D system. Percutaneous transtracheal ventilation by the Arrow EID adequately ventilated dogs with controlled partial (95%) or complete airway obstruction from hypoxic and hypercarbic states. The ease of insertion, decreased associated complications, ability to ventilate with easily available devices, and use with complete airway obstruction make the EID an effective device for transtracheal ventilation.