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VOLUME 3 , ISSUE 1 ( 2018 ) > List of Articles


Innovative Use of Cook's Pediatric Airway Exchange Catheter in Difficult Tracheostomies

Aparna A Nerurkar, Ruchi A Jain, Bharati A Tendolkar, Smita S Lele

Keywords : Cook's pediatric airway exchange catheter, Tracheal stenosis, Tracheostomies.

Citation Information : Nerurkar AA, Jain RA, Tendolkar BA, Lele SS. Innovative Use of Cook's Pediatric Airway Exchange Catheter in Difficult Tracheostomies. Res Inno Anesth 2018; 3 (1):26-28.

DOI: 10.5005/jp-journals-10049-0044

License: CC BY-SA 4.0

Published Online: 01-04-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Tracheostomy is a routine airway procedure performed by surgeons and anesthesiologists. However, it is a life-saving procedure in cases of severe tracheal stenosis secondary to traumatic airway injuries, or prior tracheal surgeries. Tracheostomy is challenging in these situations even in experienced hands, especially in an emergency setting, and there can be a fatal loss of airway. Cook's pediatric airway exchange catheter can be successfully used in such cases to safely achieve an appropriatesized tracheostomy even in adults. Initial transtracheal airway access is achieved with a smaller (internal diameter 3.5–4.5 mm) uncuffed endotracheal tube (ETT) to relieve obstruction and improve oxygenation. Railroading of bigger tubes over a Cook's pediatric airway exchange catheter inserted into the smaller ETT is then sequentially done to achieve a desired size of tracheostomy without loss of airway or compromised oxygenation. We describe five cases of difficult tracheostomy with the use of this technique.

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