Percutaneous needle cricothyroidotomy with repetitive airway obstruction. 1995

M Hauswald, and G Ong, and E Yeoh
University of New Mexico School of Medicine, Department of Emergency Medicine, Albuquerque 87131-5246, USA.

To develop a technique for needle cricothyrotomy that mimics the normal respiratory cycle (using repetitive obstruction of the upper airway and relatively low flow oxygen through small catheters), a controlled trial in three anesthetized dogs was performed. Oxygen from a standard bottle and pressure reducer was delivered through the cricothyroid membrane at 0.36 L/kg/min, which is metabolically equivalent to 0.2 L/kg/min in an adult human. The upper airway was obstructed until the chest rose and then was unobstructed to allow exhalation. The animals were ventilated for 5 minutes to allow equilibration. Arterial PCO2 was measured after 2-minute periods of apnea and 3 minutes of ventilation, each repeated four times. The procedure was repeated in three other dogs at a flow of 0.18 L/kg/min to simulate a 50% air leak. Cricothyroid ventilation at 0.36 L/kg/min lowered the PCO2 from 65 mm Hg to 43 mm Hg, F = 258, P = .004. All PCO2 after 25 minutes were in the normal range. Ventilation at 0.18 L/kg/min stabilized the PCO2 at approximately 1.5 times normal (67 mm Hg versus 79 mm Hg for the preceding apnea, F = 77, P = .013). Flow rates achievable with 18- to 20-gauge catheters and standard oxygen sources are adequate for cricothyroid ventilation when the airway is repetitively obstructed to allow a normal respiratory cycle.

UI MeSH Term Description Entries
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D011677 Punctures Incision of tissues for injection of medication or for other diagnostic or therapeutic procedures. Punctures of the skin, for example may be used for diagnostic drainage; of blood vessels for diagnostic imaging procedures. Micropunctures,Micropuncture,Puncture
D001784 Blood Gas Analysis Measurement of oxygen and carbon dioxide in the blood. Analysis, Blood Gas,Analyses, Blood Gas,Blood Gas Analyses,Gas Analyses, Blood,Gas Analysis, Blood
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D003413 Cricoid Cartilage The small thick cartilage that forms the lower and posterior parts of the laryngeal wall. Cartilage, Cricoid,Cartilages, Cricoid,Cricoid Cartilages
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D006611 High-Frequency Jet Ventilation Respiratory support system used primarily with rates of about 100 to 200/min with volumes of from about one to three times predicted anatomic dead space. Used to treat respiratory failure and maintain ventilation under severe circumstances. Ventilation, High Frequency Jet,High Frequency Jet Ventilation,High-Frequency Jet Ventilations,Jet Ventilation, High-Frequency,Jet Ventilations, High-Frequency,Ventilation, High-Frequency Jet,Ventilations, High-Frequency Jet
D000402 Airway Obstruction Any hindrance to the passage of air into and out of the lungs. Choking,Airway Obstructions,Obstruction, Airway,Obstructions, Airway
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D013961 Thyroid Gland A highly vascularized endocrine gland consisting of two lobes joined by a thin band of tissue with one lobe on each side of the TRACHEA. It secretes THYROID HORMONES from the follicular cells and CALCITONIN from the parafollicular cells thereby regulating METABOLISM and CALCIUM level in blood, respectively. Thyroid,Gland, Thyroid,Glands, Thyroid,Thyroid Glands,Thyroids

Related Publications

M Hauswald, and G Ong, and E Yeoh
November 1961, The American journal of nursing,
M Hauswald, and G Ong, and E Yeoh
August 2004, Anesthesia and analgesia,
M Hauswald, and G Ong, and E Yeoh
March 2007, Anaesthesia,
M Hauswald, and G Ong, and E Yeoh
May 1997, Chest,
M Hauswald, and G Ong, and E Yeoh
March 1998, Chest,
M Hauswald, and G Ong, and E Yeoh
July 2021, BMJ case reports,
M Hauswald, and G Ong, and E Yeoh
June 1999, Pediatric emergency care,
M Hauswald, and G Ong, and E Yeoh
November 2014, The American journal of emergency medicine,
M Hauswald, and G Ong, and E Yeoh
January 2004, The American journal of emergency medicine,
Copied contents to your clipboard!