Mallam et al. & Response by Böttinger et al. Near total intrathoracic airway obstruction managed with a Tritube® and flow-controlled ventilation. Anaesthesia Reports 2022

Dr. Mallam and colleagues present the case of an emergent near total airway obstruction which was managed using Tritube and Evone. Given the severity of the obstruction, Tritube was considered as first choice for airway management and facilitated a secure airway past the lesion. Subsequently, the authors describe device-related problems they were facing during the procedure, which are referred to in the corresponding publication by Ventinova (see Böttinger et al., Anaesthesia Reports 2022). Overall, the authors state that Tritube in combination with FCV still represents the most preferrable strategy in patients with likewise pathology, precluding the need for HFJV or ECMO. This case report vividly demonstrates that adequate training is key to allow safe and efficient application of FCV, including the importance to have a well-prepared rescue strategies as backup at hand. In the corresponding reply by Böttinger et al., Ventinova Medical addresses the device-related complications described in the case report by Mallam et al. A brief recap is given on the voluntarily filed field safety notice which was handled to the satisfaction of involved competent authorities and led to the release of a software upgrade of Evone. Furthermore, the authors emphasize that Ventrain – if applied correctly – represents the safest and most efficient device for ventilation in a (near) complete airway obstruction.