Chapter 11 - Airway manipulation with tracheotomy

Summary

Within the past 30 years, there have been numerous improvements in advanced airway management. This chapter describes many techniques that use currently available medical equipment that might be used in its intended application or in an off-label usage. To minimize the potential for complications, tracheotomy removal and reinsertion can be accomplished with the aid of a guiding catheter. Management of complications of tracheal site manipulations is directed primarily at restoration of a patent airway. One of the main differences between lung isolation techniques is the ability to provide selective ventilation versus selective isolation of ventilation. An obstructing or even non-obstructing lesion in the airway can greatly affect an anesthesia provider's choice for lung isolation. In patients with pre-existing tracheotomy stomas, selective ventilation can also be achieved by direct placement of a single lumen endotracheal tube into the desired mainstem bronchus.