Tracheal Tube Exchange: Feasibility of Continuous Glottic Viewing with Advanced Laryngoscopy Assistance

In Brief Trachea tube exchange via an airway exchange catheter is commonly combined with conventional laryngoscopy to assist intubation of the trachea. Glottic visualization may not be possible in the difficult airway. A delay in reintubation, airway injury, or intubation failure may complicate “blind” tracheal intubation because of excessive endotracheal tube size or tip impingement on airway structures. Advanced laryngoscopic techniques offering “around the corner” visualization may overcome many of the limitations of conventional laryngoscopy's “line of sight.” In this data review, I examined the feasibility and usefulness of transforming a high-risk exchange from a blind procedure into one with improved glottic visualization. IMPLICATIONS: Exchanging an endotracheal tube in the difficult airway patient with the adjunct use of advanced laryngoscopy appears feasible, offering improved visualization of the glottic structures when compared with conventional laryngoscopy.