critical care medicine
How To Insert an Esophageal Tracheal Double Lumen Tube (Combitube) or a King Laryngeal Tube
Additional Considerations for Combitube or King Laryngeal Tube Insertion
The balloon cuffs of the Combitube are inflated individually. The balloon cuffs of the King laryngeal tube share a single pilot tube and inflate simultaneously. An estimated 1 to 5% of Combitube insertions enter the trachea; in these cases, if the misplacement is recognized, the cuffed distal lumen can be used to function as an endotracheal tube. Probably at least 10% of insertions done with newer King laryngeal tubes enter the trachea; ventilation may be possible through the distal lumen in these cases. Older King tubes are contoured such that virtually all insertions enter the esophagus. The ventilating lumen of the King tube is suitable for stylet insertion to facilitate conversion of the King tube to an endotracheal tube. However, visualization of the glottis through this lumen is often impossible. 