Die Bedeutung des ösophago-trachealen Kombinationstubus in der klinischen Routine und bei Notfällen

Zusammenfassung

Das Erkennen einer Atemwegsbehinderung bei Patienten und dessen rasche Beseitigung zur Erhaltung einer adäquaten Spontanatmung bzw. Durchführung einer suffizienten Beatmung zählen zu den vorrangigen Aufgaben jedes Arztes und Laien. Der Kombitubus (Tyco-Healthcare, Neustadt/Donau; www.combitube.org) stellt als Alternative zum goldenen Standard des Endotrachealtubus (ETT) eine sichere Methode im „Difficult Airway Management” dar. Nach langjähriger Verwendung in präklinischen und klinischen Notfallsituationen hat der Kombitubus nun auch in der klinischen Routine seine anästhesiologisch-intensivmedizinische Bedeutung erlangt. Das anästhesiologische Management beim Einsatz des Kombitubus unterscheidet sich nicht wesentlich von demjenigen bei anderen „Difficult Airway” Situationen. Der Gebrauch des Kombitubus muss jedoch durch entsprechende Ausbildung und regelmäßiges Training erlernt werden.

Abstract

Difficult intubation can unexpectedly occur in clinical practice and emergencies. Oxygenation must be maintained with resumed artificial ventilation. Besides tracheal intubation with an ETT as the „gold standard” of airway management, the esophageal-tracheal Combitube® (ETC; Tyco-Healthcare, Neustadt/Donau, Germany; www.combitube.org) is another interesting device that has been used satisfactorily in a variety of circumstances, specially for management of the difficult airway. The ETC has been used during prehospital and hospital emergencies. Now, anesthesiologists have managed the ETC successfully in clinical practice also. The anesthesiological management does not differ from the management in other difficult airway situations. The use of the Combitube needs an appropriate teaching and continuous clinical practice.

Schlüsselwörter

Ösophago-trachealer Kombitubus (Combitube®) - Vor- und Nachteile in der klinischen Routine und bei Notfällen - Anästhesiologisches Management

Key words

Esophageal-tracheal-Combitube® (ETC) - Advantages and disadvantages in clinical use and emergencies - Management of the airway

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