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Tritube

Easy airway access.

Ultra thin ventilation tube

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 patients > 40 kg. Tritube can exclusively be used together with Evone® or Ventrain® .

Applications:

Tritube has three lumen:

Tritube (including its cuff) is completely manufactured of high-quality Polyurethane (PU). Moreover, Tritube has a malleable stylet to facilitate intubation.

ADVANTAGES

Additional Information

Filauro et al. Evone® Flow controlled ventilation: a new device for laryngotracheal surgery. Acta Otorhinolaryngol Ital. 2022
Nouraei et al. A multidisciplinary approach for managing the infraglottic difficult airway in the setting of the Coronavirus pandemic. Oper Tech Otolaryngol Head Neck Surg. 2020
Mallam et al. & Response by Böttinger et al. Near total intrathoracic airway obstruction managed with a Tritube® and flow-controlled ventilation. Anaesthesia Reports 2022
Leow et al. Intubation with a TriTube to avoid peri-operative tracheostomy in open airway surgery. The Journal of Laryngology & Otology, 1-16. doi:10.1017/S002221512200024X
Bialka et al. Flow-controlled ventilation – a new and promising method of ventilation presented with a review of the literature. Anaesthesiol Intensive Ther 2022; 54, 1: 1–9
Yilbas AA et al. Experience with Tritube and Flow-Controlled Ventilation During Airway Surgery. Turk J Anaesthesiol Reanim. 2021;49(3):269-270.
Bailey JR et al. Laryngectomy with a Tritube® and flow-controlled ventilation. Anaesth Rep. 2021 May 7;9(1):86-89. doi: 10.1002/anr3.12114.
Shallik N et al. Management of critical tracheal stenosis with a straw sized tube (Tritube): Case report. Qatar Med J. 2021 Jan 28;2020(3):48. doi: 10.5339/qmj.2020.48.
Schleicher A and Groeben H. Anesthetic considerations for tracheobronchial surgery. J Thorac Dis. 2020 Oct;12(10):6138-6142. doi: 10.21037/jtd.2020.02.52.
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;e13863. doi: 10.1111/ijcp.13863. Online ahead of print.
Meulemans et al. Evone® Flow-Controlled Ventilation During Upper Airway Surgery: A Clinical Feasibility Study and Safety Assessment. Front. Surg. 2020; 7:6.
Schmidt et al. Glottic visibility for laryngeal surgery: Tritube® vs. microlaryngeal tube – a randomized controlled trial. Eur J Anaesthesiol. 2019; 36:963-971
Piosik et al. Ultra-narrow 2.4 mm id Tritube® together with Evone® ventilation allows surgical access and controlled ventilation even in case of severe stenosis. Trends in Anaesthesia and Critical Care 2018 (23); 20
Rodríguez et al. Cutting-edge ventilation method in laryngeal microsurgery. Abstract #3280 presented at Euroanaesthesia 2019
Kristensen et al. 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 #3755 presented at Euroanaesthesia 2019 – Manuscript in preparation
Schmidt et al. Flow-controlled ventilation during ear, nose and throat surgery. A prospective observational study. Eur J Anaesthesiol. 2019
Jeyarajah and Ahmad. Awake tracheal placement of the Tritube® under flexible bronchoscopic guidance. Anaesthesia Cases / 2018-0097 / ISSN 2396-8397 epub Jul 2018
De Wolf et al. A prototype small-bore ventilation catheter with a cuff: cuff inflation optimizes ventilation with the Ventrain. Acta Anaesth Scand 2017

Silva et al. Personalized Mechanical Ventilation Settings: Slower Is Better! In: Annual Update in Intensive Care and Emergency Medicine 2022
Bialka et al. Flow-controlled ventilation – a new and promising method of ventilation presented with a review of the literature. Anaesthesiol Intensive Ther 2022; 54, 1: 1–9
Van Dessel E et al. Ventilatory efficiency is improved during flow-controlled ventilation in ARDS. Intensive Care Medicine Experimental 2020, 9(1):001167.
Spraider P et al. A case report of individualized ventilation in a COVID-19 patient – new possibilities and caveats to consider with flow-controlled ventilation. BMC Anesthesiol. 2021 May 12;21(1):145.
Wittenstein J et al. Comparative effects of flow vs. volume-controlled one-lung ventilation on gas exchange and respiratory system mechanics in pigs. Intensive Care Med Exp. 2020 Dec 18;8(Suppl 1):24. doi: 10.1186/s40635-020-00308-0
Sebrechts T et al. Flow-controlled ventilation with the Evone ventilator and Tritube versus volume-controlled ventilation. Eur J Anaesthesiol. 2021 Feb 1;38(2):209-211. doi: 10.1097/EJA.0000000000001326
Spraider P et al. Individualized flow-controlled ventilation compared to best clinical practice pressure controlled ventilation: a prospective randomized porcine study. Int J Crit Care 2020 Nov 25;24(1):662. doi: 10.1186/s13054-020-03325-3.
Meulemans et al. Evone® Flow-Controlled Ventilation During Upper Airway Surgery: A Clinical Feasibility Study and Safety Assessment. Front. Surg. 2020; 7:6.
Weber et al. Flow-controlled ventilation (FCV) improves regional ventilation in obese patients – a randomized controlled crossover trial. BMC Anesthesiol 2020;20(1):24
Schmidt et al. Flow-Controlled Ventilation Attenuates Lung Injury in a Porcine Model of Acute Respiratory Distress Syndrome: A Preclinical Randomized Controlled Study. Crit Care Med. 2020 Mar;48(3):e241-e248
Weber et al. Flow-controlled ventilation improves gas exchange in lung-healthy patients – a randomised interventional cross-over study. Acta Anaesthesiol Scand. 2019 Dec 12. doi: 10.1111/aas.13526. [Epub]
Bergold et al. Flow-controlled ventilation – a novel approach to treating severe acute respiratory distress syndrome. Poster presented at WAMM 2019.
Schmidt et al. Glottic visibility for laryngeal surgery: Tritube® vs. microlaryngeal tube – a randomized controlled trial. Eur J Anaesthesiol. 2019; 36:963-971
Spraider et al. Improved ventilation and lung recruitment in flow-controlled ventilation (FCV) compared to pressure-controlled ventilation (PCV) – A prospective, randomized porcine study. Abstract presented at ESICM 2019 and AIC 2019.
Doyle. Ventilation via Narrow-Bore Catheters: Clinical and Technical Perspectives on the Ventrain Ventilation System. The Open Anaesthesia Journal Sep 2018; 12, 49-60
Schmidt et al. Improved lung recruitment and oxygenation during mandatory ventilation with a new expiratory ventilation assistance device: Eur J Anaesthesiol. 2018 Oct;35(10):736-744
Berry et al. Percutaneous transtracheal ventilation in an obstructed airway model in post apnoeic sheep. Br J Anaesth. 2014
Paxian et al. Transtracheal ventilation with a novel ejector-based device (Ventrain) in open, partly obstructed, or totally closed upper airways in pigs. Br J Anaesth 2015
Silva et al. Personalized Mechanical Ventilation Settings: Slower Is Better! In: Annual Update in Intensive Care and Emergency Medicine 2022
Spraider P et al. A case report of individualized ventilation in a COVID-19 patient – new possibilities and caveats to consider with flow-controlled ventilation. BMC Anesthesiol. 2021 May 12;21(1):145.
Ordies S et al. Flow-controlled ventilation during EVLP improves oxygenation and preserves alveolar recruitment. Intensive Care Med Exp. 2020 Nov 25;8(1):70. doi: 10.1186/s40635-020-00360-w.
Wittenstein J et al. Comparative effects of flow vs. volume-controlled one-lung ventilation on gas exchange and respiratory system mechanics in pigs. Intensive Care Med Exp. 2020 Dec 18;8(Suppl 1):24. doi: 10.1186/s40635-020-00308-0
Weber et al. Flow-controlled ventilation (FCV) improves regional ventilation in obese patients – a randomized controlled crossover trial. BMC Anesthesiol 2020;20(1):24
Schmidt et al. Flow-Controlled Ventilation Attenuates Lung Injury in a Porcine Model of Acute Respiratory Distress Syndrome: A Preclinical Randomized Controlled Study. Crit Care Med. 2020 Mar;48(3):e241-e248
Bergold et al. Flow-controlled ventilation – a novel approach to treating severe acute respiratory distress syndrome. Poster presented at WAMM 2019.
Spraider et al. Improved ventilation and lung recruitment in flow-controlled ventilation (FCV) compared to pressure-controlled ventilation (PCV) – A prospective, randomized porcine study. Abstract presented at ESICM 2019 and AIC 2019.
Barnes and Enk. Ventilation for low dissipated energy achieved using flow control during both inspiration and expiration. Trends in Anaesthesia and Critical Care 24 (2019); 5-12
Barnes et al. Minimisation of dissipated energy in the airways during mechanical ventilation by using constant inspiratory and expiratory flows-Flow controlled ventilation (FCV). Medical Hypotheses 121 (2018); 167-176
Filauro et al. Evone® Flow controlled ventilation: a new device for laryngotracheal surgery. Acta Otorhinolaryngol Ital. 2022
Nouraei et al. A multidisciplinary approach for managing the infraglottic difficult airway in the setting of the Coronavirus pandemic. Oper Tech Otolaryngol Head Neck Surg. 2020
Mallam et al. & Response by Böttinger et al. Near total intrathoracic airway obstruction managed with a Tritube® and flow-controlled ventilation. Anaesthesia Reports 2022
Leow et al. Intubation with a TriTube to avoid peri-operative tracheostomy in open airway surgery. The Journal of Laryngology & Otology, 1-16. doi:10.1017/S002221512200024X
Bialka et al. Flow-controlled ventilation – a new and promising method of ventilation presented with a review of the literature. Anaesthesiol Intensive Ther 2022; 54, 1: 1–9
De Wolf et al. Ventilation through small-bore airways in children by implementing active expiration. Pediatric Anesthesia. 2022;32:312–320.
Dos Santos Rocha et al. Novel ventilation techniques in children. Paediatr Anaesth. 2021 Nov 27. doi: 10.1111/pan.14344. Epub ahead of print. PMID: 34837438.
Piccioni F et al. Use of the Ventrain Ventilation Device and an Airway Exchange Catheter to Manage Hypoxemia During Thoracic Surgery and One-Lung Ventilation. J Cardiothorac Vasc Anesth. 2021 Jun 25:S1053-0770(21)00529-2. doi: 10.1053/j.jvca.2021.06.023. Epub ahead of print. PMID: 34294514.
Yilbas AA et al. Experience with Tritube and Flow-Controlled Ventilation During Airway Surgery. Turk J Anaesthesiol Reanim. 2021;49(3):269-270.
Bailey JR et al. Laryngectomy with a Tritube® and flow-controlled ventilation. Anaesth Rep. 2021 May 7;9(1):86-89. doi: 10.1002/anr3.12114.
Shallik N et al. Management of critical tracheal stenosis with a straw sized tube (Tritube): Case report. Qatar Med J. 2021 Jan 28;2020(3):48. doi: 10.5339/qmj.2020.48.
Schleicher A and Groeben H. Anesthetic considerations for tracheobronchial surgery. J Thorac Dis. 2020 Oct;12(10):6138-6142. doi: 10.21037/jtd.2020.02.52.
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;e13863. doi: 10.1111/ijcp.13863. Online ahead of print.
Meulemans et al. Evone® Flow-Controlled Ventilation During Upper Airway Surgery: A Clinical Feasibility Study and Safety Assessment. Front. Surg. 2020; 7:6.
Schmidt et al. Glottic visibility for laryngeal surgery: Tritube® vs. microlaryngeal tube – a randomized controlled trial. Eur J Anaesthesiol. 2019; 36:963-971
Morrison et al. The Ventrain Device: A Future Role in Difficult Airway Algorithms? A&A Practice. 2019;13:362-365
Piosik et al. Ultra-narrow 2.4 mm id Tritube® together with Evone® ventilation allows surgical access and controlled ventilation even in case of severe stenosis. Trends in Anaesthesia and Critical Care 2018 (23); 20
Rodríguez et al. Cutting-edge ventilation method in laryngeal microsurgery. Abstract #3280 presented at Euroanaesthesia 2019
Kristensen et al. 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 #3755 presented at Euroanaesthesia 2019 – Manuscript in preparation
Zuercher et al. Combined use of Ventrain and S-Guide for Airway Management of Severe Subglottic Stenosis. Turk J Anaesthesiol Reanim. 2019;47(3):238-241. doi:10.5152/TJAR.2019.75428
Schmidt et al. Flow-controlled ventilation during ear, nose and throat surgery. A prospective observational study. Eur J Anaesthesiol. 2019
Doyle. Ventilation via Narrow-Bore Catheters: Clinical and Technical Perspectives on the Ventrain Ventilation System. The Open Anaesthesia Journal Sep 2018; 12, 49-60
Jeyarajah and Ahmad. Awake tracheal placement of the Tritube® under flexible bronchoscopic guidance. Anaesthesia Cases / 2018-0097 / ISSN 2396-8397 epub Jul 2018
Heuveling et al. Transtracheal Use of the CriCath Cannula in Combination With the Ventrain Device for Prevention of Hypoxic Arrest due to Severe Upper Airway Obstruction: A Case Report. A A Pract. 2018 Dec 15;11(12):344-347
Escribá et al. Emergency Ventilation of Infant Subglottic Stenosis Through Small-Gauge Lumen Using the Ventrain: A Case Report. A A Prac 2018 Mar 15;10(6):136-138
Kristensen et al. Ventilation via the 2.4 mm internal diameter Tritube® with cuff – new possibilities in airway management. Acta Anesthesiol. Scand. 2017 Jul; 61(6):580-589
De Wolf et al. Emergency ventilation with the Ventrain_through an airway exchange catheter in a porcine model of complete upper airway obstruction. Can J Anaesth. 2017 Jan;64(1):37-44
Schmidt et al. Monitoring in- and expiratory tidal volumes in the new Ventrain® emergency ventilation device. Poster Airway management symposium 2013
Enk et al. Small Lumen Ventilation through a Cuffed Jet Ventilation Catheter: Efficiency and Safety. Poster Airway Management 2012
Dias et al. Adequate minute volume ventilation through a 100 cm long, 3 mm inner diameter airway exchange catheter by expiratory ventilation assistance (EVA). Poster ESA 2012
Calderon et al. Expiratory ventilation assistance (EVA) through a 14G catheter (2mm) in a Totally Obstructed Airway (TOA). Poster SAM 2013
Hamaekers et al. A bench study of ventilation via two self-assembled jet devices and the Oxygen Flow Modulator in simulated upper airway obstruction. Anaesthesia. 2009 Dec;64(12):1353-8
Hamaekers et al. The importance of flow and pressure release in emergency jet ventilation devices. Paediatr Anaesth. 2009 May;19(5):452-7
Hamaekers et al. Achieving an adequate minute volume through a 2 mm transtracheal catheter in simulated upper airway obstruction using a modified industrial ejector. Br J Anaesth. 2010
Hamaekers et al. Ventilation through a small-bore catheter: optimizing expiratory ventilation assistance. Br J Anaesth. 2011
Hamaekers, et al. Ventrain: an ejector ventilator for emergency use. Br J Anaesth. 2012 Jun; 108 (6): 1017-21
Manoach et al. Resuscitation from prolonged apnea and upper airway obstruction in a large ovine model: a pilot trial of transtracheal ventilation using 15 lpm with and without an entrainment assisted trans-catheter exhalation device. Poster SAM 2011
Ziebart et al. Pulmonary effects of expiratory-assisted small-lumen ventilation during upper airway obstruction in pigs. Anaesthesia. 2015
Berry et al. Percutaneous transtracheal ventilation in an obstructed airway model in post apnoeic sheep. Br J Anaesth. 2014
Hamaekers et al. Rescue ventilation through a small-bore transtracheal cannula in severe hypoxic pigs using expiratory ventilation assistance. Anesth Analg. 2015 Apr; 120 (4):890-4
Paxian et al. Transtracheal ventilation with a novel ejector-based device (Ventrain) in open, partly obstructed, or totally closed upper airways in pigs. Br J Anaesth 2015
Kalsi et al. Transtracheal jet ventilation using the Ventrain Device in a patient with severe upper airway obstruction. Poster DAS 2012
Nellgård. Ventrain in a case of can´t intubate can´t ventilate situation. Abstract ESA 2013
Krapf et al. Cannot intubate, cannot ventilate: Beatmung über einen 2-mm-Katheter in der Präklinik. Notfallpraxis 2016 8(39); 792-794 (article in German)
López-Torres et al. Ventrain device for difficult or obstructed airway: 4 case report. Abstracts / Trends in Anesthesia and Critical Care 2017; 12:31
Willemsen et al. Ventilation with the Ventrain through a small lumen catheter in the failed paediatric airway: two case reports. Br J Anaest 2014
Wahlen et al. Ventrain: from theory to practice. Bridging until re-tracheostomy BJM Case Rep 2017
Escribá Alepuz et al. Emergency Ventilation of Infant Subglottic Stenosis Through Small-Gauge Lumen Using the Ventrain: A Case Report. A&A Case Reports. Oct 24 2017
Van der Beek et al. Optimizing ventilation through a cuffed narrow bore catheter (CNBC) using expiratory ventilation assistance (EVA): an animal study. Poster ESA 2013
Paxian et al. Transtracheal ventilation with a novel ejector-based device (Ventrain) in open, partly obstructed, or totally closed upper airways in pigs. Br J Anaesth 2015
De Wolf et al. A prototype small-bore ventilation catheter with a cuff: cuff inflation optimizes ventilation with the Ventrain. Acta Anaesth Scand 2017
Braga et al. Ventrain ejector ventilation as a bridge to tracheal intubation for complex MOMA pathology – Poster WAMM 2015
Kalkoff. Ventilation through a small-bore intubating catheter using Ventrain in an elective procedure. Letter Br J Anaesth 2012
Monnier et al. Transthyrohyoid access to the larynx for endoscopic resection of early-stage glottic cancer. Head Neck 2016 Apr
Borg et al. Ventrain for ventilation of the lungs. Br J Anaesth. 2012 Nov
Fearnley et al. Elective use of the Ventrain for upper airway obstruction during high frequency jet ventilation. J Clin Case Rep 2016
Onwochei et al. Two-Stage Technique Used to Manage Severe Upper Airway Obstruction and Avoid Surgical Tracheostomy: A Case Report. A&A Case Rep 2017
Rosenblatt and Popescu. Master techniques in Upper and Lower Airway Management. Wolters Kluwer Health (publisher); 2015
Dornberger. Schwieriges Atemwegsmanagement bei Erwachsenen und Kindern. Thieme (publisher); 2013
Spies et al. SOPs in Anästesiologie und Schmerztherapie. Thieme (publisher); 2013
Barash et al. Clinical Anesthesia, 7th ed., Wolters Kluwer Health (publisher); 2013
Hagberg, Benumof & Hagberg’s Airway Management, 3th ed. Elsevier (publisher); 2013
Hagberg, Benumof & Hagberg’s Airway Management, 4th ed. Elsevier (publisher); 2018
Timmermann et al. Need to consider human factors when determining first-line technique foremergency front-of-neck access. Br J Anaesth. 2016 May 20
Noppens. Ventilation through a ‘straw’: the final answer in a totally closed upper airway? Br J Anaesth. 2015
Böttinger and Van der Hoorn. Negative pressure ventilation – a special application of expiratory ventilation assistance. Intensive Care Med Exp 2019, 7(1), 22
Berlin et al. Automated expiratory ventilation assistance through a small endotracheal tube can improve venous return and cardiac output. Intensive Care Med Exp. 2019, 7(1), 6
Schmidt et al. Monitoring in- and expiratory tidal volumes in the new Ventrain® emergency ventilation device. Poster Airway management symposium 2013
Enk et al. Small Lumen Ventilation through a Cuffed Jet Ventilation Catheter: Efficiency and Safety. Poster Airway Management 2012
Dias et al. Adequate minute volume ventilation through a 100 cm long, 3 mm inner diameter airway exchange catheter by expiratory ventilation assistance (EVA). Poster ESA 2012
Calderon et al. Expiratory ventilation assistance (EVA) through a 14G catheter (2mm) in a Totally Obstructed Airway (TOA). Poster SAM 2013
Hamaekers et al. A bench study of ventilation via two self-assembled jet devices and the Oxygen Flow Modulator in simulated upper airway obstruction. Anaesthesia. 2009 Dec;64(12):1353-8
Hamaekers et al. The importance of flow and pressure release in emergency jet ventilation devices. Paediatr Anaesth. 2009 May;19(5):452-7
Hamaekers et al. Achieving an adequate minute volume through a 2 mm transtracheal catheter in simulated upper airway obstruction using a modified industrial ejector. Br J Anaesth. 2010
Hamaekers et al. Ventilation through a small-bore catheter: optimizing expiratory ventilation assistance. Br J Anaesth. 2011
Hamaekers, et al. Ventrain: an ejector ventilator for emergency use. Br J Anaesth. 2012 Jun; 108 (6): 1017-21