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Combitube Airway May Be Headed for Space

A comparative study during parabolic flight favors the Mallinckrodt® Combitube® esophageal/tracheal double-lumen airway for future space shuttle use

Pleasanton, Calif. – A recent study to evaluate endotracheal tube performance in microgravity conditions determined that the Combitube® esophageal/tracheal double-lumen airway may have an edge over standard endotracheal (ET) tubes.

During prolonged space shuttle missions, there may be an increased risk of hypoxic cardiopulmonary arrest, aspiration of foreign bodies and burns.1 As a result, the space shuttle currently carries endotracheal tubes and a tracheostomy kit on board. Under conditions of weightlessness, however, performing an invasive tracheostomy and placing an ET tube may be extremely difficult and risky. Because it is not known which non-surgical airway is best under conditions of microgravity, a study titled, “Airway management with endotracheal tube versus Combitube during parabolic flights” was conducted. The study defined “best” as an airway that requires minimal training to use, is easy to insert and has a high degree of success.

The panel conducting the study chose the Combitube airway over other supraglottic alternative airway devices due to its safety against aspiration,2,3 applicability of high ventilatory pressures,4,5 immediate fixation,6 ease of insertion,7,8 and slim design9 (making it helpful in patients with a small interincisor distance).

The experiment involved the comparison of speed, accuracy and subjective ease of insertion of the standard ET tube versus the Combitube airway in airway mannequins. Using the Combitube airway, success rates were 100% (29/29 attempts) under normogravity conditions and 91% (30/33) during microgravity. Standard ET tube success rates were 86% (25/29 attempts) in both normogravity and microgravity conditions. Under microgravity, intubation attempts using the Combitube airway were rated as very easy (3%) or easy (55%), whereas only 24% of the intubation attempts using the ET tube under microgravity were rated as easy (0 attempts were rated as very easy).

The paramedic flyers performing the intubations remarked that much more skill and concentration were required to perform the ET tube procedure as compared with the Combitube airway procedure. Since the Combitube airway requires no surgical procedure and is easier to insert than a standard ET tube, it was recommended for further study as an alternative to the conventional ET tubes currently on board the space shuttle.

The Combitube® esophageal/tracheal double-lumen airway is one of the most trusted and researched supraglottic airways available on the market. With over 200 independent clinical studies showing it to be a safe and effective product in emergency or surgical use, the Combitube airway is widely recommended in difficult airway algorithms for “can’t intubate, can’t ventilate” scenarios.

About Nellcor Puritan Bennett

Nellcor Puritan Bennett is dedicated to developing innovative, clinically relevant medical products with an emphasis on noninvasive patient safety monitoring and respiratory care. A part of Tyco Healthcare, Nellcor Puritan Bennett is the world’s foremost supplier of acute care ventilation and airway management products. For more information, visit www.nellcor.com.

About Tyco Healthcare

As a major business segment of Tyco International Ltd. (NYSE:TYC), Tyco Healthcare manufactures, distributes and services an extensive product line including disposable medical supplies, monitoring equipment, innovative wound closure products, advanced surgical devices, medical instruments and bulk analgesic pharmaceuticals. With industry-leading brand names such as Autosuture, Kendall, Mallinckrodt, Nellcor, Puritan Bennett, Syneture and Valleylab, Tyco Healthcare products are found in virtually every healthcare setting. For further information, please visit the website at www.tycohealthcare.com.