The Difficult Airway in Adult Critical Care

Gavin G. Lavery, MD, FCARSCI, MB, BCh, BAO; Brian V. McCloskey, MB, BCh, FRCA, FFARCSI, MRCP


Crit Care Med. 2008;36(7):2163-2173. 

In This Article

Combitube (Esophageal-Tracheal Double-Lumen Airway)

The Combitube (Tyco-Kendall-Sheridan, Manstield, MA) is a combined esophageal obturator and tracheal tube and is usually inserted blindly.[15,24,97,115,133,134,135] Whether the tracheal lumen is placed in the trachea or esophagus, the Combitube (Fig. 5) will allow ventilation of the lungs and give partial protection against aspiration. In many situations, the Combitube is a (less widely used) alternative to the LMA, including the cannot intubate-cannot ventilate situation. Disadvantages include the inability to suction the trachea when placed in the esophagus (the most common position). Insertion may also cause trauma and is contraindicated in patients with known esophageal pathology, intact laryngeal reflexes, or in those who have ingested caustic substances.

Combitube (allowing pulmonary ventilation if tube is inserted into the esophagus). Reproduced with permission from Daniele Focosi's Molecular Medicine Web site ( ). Accessed May 29, 2008.


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