The Combitube (Fig 4), which is introduced blindly into the mouth, is a double-lumen tube with a small-volume distal cuff and a large-volume (100 ml) proximal cuff.
One channel opens distally, while the other has a blind end with side-openings between the two cuffs. If the tube enters the trachea, the distal cuff is inflated and the distally opening channel is used as if for conventional orotracheal intubation. If the tube enters the esophagus, the distal cuff is inflated to protect against regurgitation and pulmonary aspiration, the proximal cuff is inflated to form an air-tight seal in the hypopharynx, and ventilation is via the blind-ended channel. Inflation pressures may be high owing to the small size of the side-openings.
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