World Library  
Flag as Inappropriate
Email this Article


Article Id: WHEBN0008658469
Reproduction Date:

Title: Combitube  
Author: World Heritage Encyclopedia
Language: English
Subject: Tracheal intubation, Emergency medical services in Hong Kong, Emergency medicine, Australasian College for Emergency Medicine, Pocket mask
Publisher: World Heritage Encyclopedia


The Combitube, also known as the double-lumen airway, is a blind insertion airway device (BIAD) used in the pre-hospital and emergency setting.[1] It is designed to provide an airway to facilitate the mechanical ventilation of a patient in respiratory distress.

Description and use

It consists of a cuffed, double-lumen tube that is inserted through the patients mouth to secure an airway and enable ventilation. Generally, the distal tube (tube two) enters the esophagus, where the cuff is inflated and ventilation is provided through the proximal tube (tube one) which opens at the level of the larynx. In the rare instance where the distal tube intubates the trachea, ventilation is provided through the distal tube. Inflation of the cuff in the esophagus allows a level of protection against aspiration of gastric content similar to that found in the laryngeal mask.[2] It is available in two sizes: 37 Fr (for patients 4 to 6 ft or 122 to 183 cm tall) and 41 Fr (for patients more than 5 ft or 152 cm tall).[3]


The simplicity of placement is the main advantage of the Combitube over endotracheal intubation. When intubating with a traditional endotracheal tube, care must be taken to visually ensure that the tube has been placed in the trachea while the dual-lumen design of the Combitube allows for ventilation to proceed regardless of esophageal or tracheal placement.

A device called the Positube, which allows for esophageal intubation detection, can be used on tube number two to rule out the intubation of the Combitube in the trachea. The Positube checks for air flow resistance on tube number two and is very helpful in checking proper Combitube placement when intubation is performed in noisy environment's.

The Combitube's ease of use makes it an option for use in the pre-hospital, emergency setting when advanced level providers capable of placing an endotracheal tube are not immediately available. The drawbacks of Combitubes are evidenced by reports of serious complications such as aspiration, esophagus perforation[4] and facial nerve dysfunction[1] associated with their use.

While it has been suggested as an option by the American Heart Association and European Resuscitation Council for situations where intubation attempts are unsuccessful since the year 2000,[5] it is seldom used outside of the pre-hospital, emergency setting, as it does not allow for long term airway control. Alternatives to the Combitube include the laryngeal mask airway, the endotracheal tube, and the laryngeal tube.

See also


  1. ^ a b Jorge E. Zamora and Tarit K. Saha, "Combitube rescue for cesarean delivery followed by ninth and twelfth cranial nerve dysfunction" Canadian Journal of Anesthesia Volume 55, Issue 11 , pp 779-784, published 2008
  2. ^ Carin A. Hagberg, Tigran N. Vartazarian, Jacques E. Chelly, Andranik Ovassapian, "The incidence of gastroesophageal reflux and tracheal aspiration detected with pH electrodes is similar with the Laryngeal Mask Airway and Esophageal Tracheal Combitube — a pilot study" Canadian Journal of Anesthesia March 2004, Volume 51, Issue 3, pp 243-249
  3. ^  
  4. ^ Marie-Claude Vézina , Pierre C. Nicole , Claude A. Trépanier , Martin R. Lessard, "Retrospective study of complications associated with the Combitube", Canadian Journal of Anesthesia June 2005, Volume 52, Issue 1 Supplement, p A125
  5. ^ International Liaison Committee on Resuscitation/European Resuscitation Council Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care—Part 6, Section 3: adjuncts for oxygenation, ventilation, and airway control Resuscitation, 46 (2000), pp. 115–125

Further reading

Ron Walls, Michael Murphy, Extraglottic devices, Manual of Emergency Airway Management, Lippincott Williams & Wilkins, 05.11.2012.

External links

  • Combitube Intubation
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.