Pregledni rad
CRICOTHYROTOMY – URGENT ACCESS TO THE AIRWAY, WHEN AND HOW?
TENA ŠIMUNJAK
; Sveučilište u Zagrebu, Medicinski fakultet, Zagreb, Hrvatska
TATJANA GORANOVIĆ
; Klinička bolnica Sveti Duh, Klinika za anesteziologiju, reanimaciju i intenzivnu medicinu, Zagreb, Sveučilište Josipa Jurja Strossmayera Osijek, Medicinski fakultet, Osijek, Hrvatska
Sažetak
Cricothyrotomy or coniotomy is an invasive emergency procedure to establish an airway for ventilation and oxygenation when other routine methods are not possible, or are contraindicated and ineffective. The indications are situations when we cannot ventilate and cannot intubate patients with severe maxillofacial trauma, edema secondary to burns of the face and airway, laryngo-hypopharyngeal obstruction of a wide range of causes such as bilateral vocal cord paralysis because of previous head and neck surgeries, endotracheal intubation, neurologic causes and laryngeal carcinomas, congenital malformations, craniofacial trauma with massive bleeding, etc. There are no absolute contraindications, while relative ones are few and include laceration of the larynx and trachea with or without retraction of the trachea in the mediastinum. In that case, tracheotomy is indicated. Cricothyrotomy is contraindicated in children. To perform the procedure, there are several techniques, i.e. standard surgical, emergency surgical procedure and percutaneous techniques. Early complications (incidence 0-54%) include bleeding, laceration of the thyroid, cricoid cartilage and tracheal rings, perforation of the rear tracheal wall, tube misinsertion, unplanned tracheostomy, wound and cartilage infection. Long-term complications include subglottic stenosis and phonation diffi culties. Cricothyrotomy is a temporary solution to obtain ventilation and oxygenation and the need for prolonged ventilation (more than 72 h) has to be replaced with tracheotomy.
Ključne riječi
critical airway; cricothyrotomy; indications; techniques
Hrčak ID:
209067
URI
Datum izdavanja:
18.11.2018.
Posjeta: 1.950 *