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CRITICAL CARE AND TRAUMA

A Comparison of Two Emergency Cricothyroidotomy Kits in Human Cadavers

Mehdi Benkhadra, MD^*, François Lenfant, MD, PhD, Wolfgang Nemetz, MD, Friedrich Anderhuber, MD, Georg Feigl, MD^*, and Jean Fasel, MD^*

From the *Division of Anatomy, University of Geneva, Geneva, Switzerland; Department of Anesthesiology and Critical Care, General Hospital, University Hospital Center, Dijon, France; Universitätsklinik für Anaesthesiologie und Intensivmedizin, Graz, Austria; and Anatomisches Institut der Karl-Franzens-Universität, Graz, Austria.

Address correspondence and reprint requests to Dr. Mehdi Benkhadra, Division d’Anatomie, Centre Médical Universitaire, 1 rue Michel Servet, 1211 Genève 4, Switzerland. Address e-mail to m.benkhadra{at}wanadoo.fr.

BACKGROUND: We compared two emergency cricothyroidotomy kits designed to avoid lesions during insertion, one based on the Seldinger technique (ST), the other based on the concept of a mechanical detection of the posterior wall of the larynx, with regard to insertion time, success rate, and complication rate.

METHODS: Cricothyroidotomy was performed under fiberoptic control in 40 human cadavers embalmed according to Thiel’s technique. The set chosen for use was randomized: new technique (NT) or ST. Duration of the procedure, success rates, and incidence of laryngeal injuries were compared. Traumatic lesions observed with the fiberoptic bronchoscope were anatomically confirmed after dissection.

RESULTS: The two groups had comparable epidemiological and anatomical records. Cricothyroidotomy was performed faster with the NT than with the ST (median 54 vs 71 s, P = 0.01). Failure rates were comparable between groups (4 vs 1, P = 0.34), and there were fewer major complications in the posterior tracheal wall with the ST (0 vs 8, P = 0.003). In the ST group, only minor punctiform lesions of the posterior trachea wall were observed in four cases.

CONCLUSIONS: In this model, despite a shorter insertion time, the NT produced more lesions and more failures than the ST.

This article has been cited by other articles:

				J. Jenvrin, D. Pean, N. Libert, T. Leclerc, S. De Rudnicki, D. A. Braude, and S. McLaughlin Cricothyroidotomy. N. Engl. J. Med., September 4, 2008; 359(10): 1073 - 1074. [Full Text] [PDF]

				Portex Cricothyrotomy Kit Doesn't Measure Up Journal Watch Emergency Medicine, February 15, 2008; 2008(215): 4 - 4. [Full Text]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999