More space during laryngo-tracheal surgery
Minimized contamination risk
Easy access to the airway
Tritube: More surgical exposure
With an outer diameter (OD) of only 4.4 mm, Tritube is an ultrathin ventilation tube, intended to obtain endotracheal access to the airway and to ventilate an adult patient. Tritube can exclusively be used together with Evone or Ventrain.
Tritube has three lumen:
• A ventilation lumen – with Murphy eye and an inner diameter (ID) smaller than 3 mm;
• A cuff lumen – to inflate and deflate the high volume, low pressure cuff;
• A pressure measurement lumen – for continuous intratracheal pressure measurements.
Tritube (including its cuff) is completely manufactured of high-quality polyurethane. Moreover, Tritube has a malleable stylet to facilitate intubation.
Potential clinical benefits
Ample clinical data clearly demonstrated clear benefits of using Tritube and Evone, managing the difficult airway or during laryngeal surgery. The following benefits were found:
- Minimized contamination risk for healthcare professionals, due to a sealed airway8
- An unprecedented view of the intubated airway, due to the thin lumen 2,5,6
- A large surgical exposure and hygienic and clear sight with non-moving vocal cords 2,4–6
- Easy intubation even in difficult airways due to the small outer diameter and malleable stylet 2,3,9
- Awake intubation in patients with a difficult airway 2,9
- Well tolerated when left in situ postoperatively, allowing patients to breathe and talk 2,3,9
- More efficient ventilation, better oxygenation and CO2 removal7,10,11
Order number 7000.
- Piazza, C. et al. Long-term intubation and high rate of tracheostomy in COVID-19 patients might determine an unprecedented increase of airway stenoses: a call to action from the European Laryngological Society. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology – Head and Neck Surgery (2020) doi:10.1007/s00405-020-06112-6.
- Kristensen, M. S., de Wolf, M. W. P. & Rasmussen, L. S. Ventilation via the 2.4 mm internal diameter Tritube® with cuff – new possibilities in airway management. Acta Anaesthesiol Scand 61, 580–589 (2017).
- Kristensen, M. S. & Abildstrøm, H. H. Endotracheal video-laryngoscope guided intubation with a 2.4 mm cuff’ed tube and active expiration by a dedicated ventilator versus a standard tube/ventilator. A randomized single blinded study in patients with a predicted difficult airway. – A paradigm shift in airway management? Abstract published at Euroanaesthesia 2019 3755, (2019).
- Schmidt, J. et al. Flow-controlled ventilation during ear, nose and throat surgery: A prospective observational study. Eur J Anaesthesiol 36, 327–334 (2019).
- Schmidt, J. et al. Glottic visibility for laryngeal surgery: Tritube vs. microlaryngeal tube: A randomised controlled trial. Eur J Anaesthesiol 36, 963–971 (2019).
- Meulemans, J. et al. Evone® Flow-Controlled Ventilation During Upper Airway Surgery: A Clinical Feasibility Study and Safety Assessment. Front. Surg. 7, (2020).
- Schmidt, J. et al. Improved lung recruitment and oxygenation during mandatory ventilation with a new expiratory ventilation assistance device: A controlled interventional trial in healthy pigs. Eur J Anaesthesiol 35, 736–744 (2018).
- Nouraei, S. A. R., Girgis, M., Shorthouse, J., El-Boghdadly, K. & Ahmad, I. A multidisciplinary approach for managing the infraglottic difficult airway in the setting of the Coronavirus pandemic. Operative Techniques in Otolaryngology-Head and Neck Surgery 31, 128–137 (2020).
- Pichi, B et al. CORONAsteps for Tracheotomy in COVID-19 Patients: A Staff-Safe Method for Airway Management. Oral oncology. 2020;105:104682
- Magasich-Airola, NP et al. Novel technique for safe tracheostomy during COVID-19 pandemic using Evone® flow-controlled ventilation system. Int J Clin Pract. 2020 Nov 27;(epub).
Instruction Tritube intubation
Instruction Ventrain Tritube ventilation
Instruction, Compliance independent ventilation via Tritube
Instruction, Compliance independent ventilation via small lumen
Instruction, Ventilation pause by Dietmar Enk
Animation Evone & Tritube
Tritube in situ, MUMC Maastricht, The Netherlands
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Erasmus Medical Center (Rotterdam, the Netherlands) is organizing a hybrid symposium on Flow Controlled Ventilation blowing away VILI.The event will be held on the 28th of October in Rotterdam but can also be watched online.For more information click...