Airway exchange catheter: Overview, Uses and Top Manufacturer Company

Posted on February 27, 2026 | by drthomas

Introduction

Airway exchange catheter is a long, semi-rigid catheter used in airway management to maintain access to the trachea (windpipe) while an endotracheal tube (ETT) is exchanged or while extubation (removal of an ETT) is performed in selected, higher-risk situations. In plain terms, it acts like a temporary “rail” or “guide” that helps clinicians remove one tube and place another with fewer interruptions to airway access.

This medical device matters because airway loss is a time-critical complication. Even in experienced hands, exchanging an ETT or re-intubating after extubation can be difficult due to swelling, bleeding, limited mouth opening, anatomy, secretions, or patient physiology. Airway exchange catheter can support safer workflows by keeping a path to the trachea available while the team performs a tube exchange or stands by after extubation.

You will encounter Airway exchange catheter across multiple hospital environments: the operating room (OR), intensive care unit (ICU), emergency department (ED), and transport settings. Its use sits at the intersection of clinical technique, team communication, device compatibility, and safety monitoring—making it relevant not only to trainees, but also to administrators, biomedical engineers, and procurement teams responsible for standardization and readiness.

This article explains:

What Airway exchange catheter is and how it functions (non-brand-specific).
Common and appropriate use cases, plus situations where it may not be suitable.
What you need before starting, including training, documentation, and hospital operations considerations.
Basic operation steps that are commonly universal across models (workflows vary by manufacturer).
Safety practices, typical failure modes, troubleshooting, and infection prevention principles.
How hospitals think about manufacturers, OEM (Original Equipment Manufacturer) relationships, distribution, and a practical global market snapshot by country.

This is informational content only. Clinical use must follow local policy, supervision, and the manufacturer’s instructions for use (IFU).

What is Airway exchange catheter and why do we use it?

Clear definition and purpose

Airway exchange catheter is a slender catheter designed to be placed into the trachea—commonly through an existing ETT—so that airway access can be maintained while the ETT is removed and replaced. Once the catheter is positioned, a new ETT can be advanced over it (“railroaded”) into the trachea, after which the catheter is removed.

Depending on the model, an Airway exchange catheter may also allow:

Oxygen insufflation (delivery of oxygen through the catheter lumen).
Sampling of exhaled gas for capnography (end-tidal carbon dioxide, EtCO2), using appropriate adapters.

Not all models support the same functions. Features and connectors vary by manufacturer.

Common clinical settings

Airway exchange catheter is used in a range of clinical environments where airway access is already established but needs to be preserved during a transition:

Operating room (OR): Tube exchanges due to cuff leak, malposition, obstruction, or a planned change in tube type (for example, changing from one ETT size to another).
ICU: Tube exchanges in patients ventilated for longer periods, where tube condition, secretion burden, cuff integrity, or airway edema may complicate re-intubation.
ED and urgent care areas: Selected cases where an initial airway was difficult and the team wants a controlled method for exchanging a tube.
Inter-facility or intra-hospital transport: When an airway is considered “high-risk” and maintaining access during transitions is operationally important.

Across these settings, the device’s value is often less about speed and more about maintaining a margin of safety during a high-stakes maneuver.

Key benefits in patient care and workflow

When used appropriately and by trained teams, Airway exchange catheter can support:

Continuity of airway access: The catheter can remain in the trachea while the tube is removed, reducing the “no tube, no access” window.
Reduced need for repeat laryngoscopy: In some exchanges, clinicians may be able to place the new tube over the catheter with less instrumentation. (Technique varies and may still require laryngoscopy.)
Standardized planning: The presence of a defined exchange workflow encourages team briefings, role assignment, and contingency planning.
Potential support for oxygenation monitoring: With appropriate equipment, the catheter may support oxygen insufflation and/or EtCO2 sampling.

From an operations perspective, the device can improve predictability: when stocked on a difficult airway cart and supported with training, it becomes a repeatable tool rather than an improvised solution.

Plain-language mechanism of action (how it functions)

A practical way to visualize the device is as a “placeholder” in the airway:

The catheter is inserted through the existing ETT until its tip sits within the trachea.
The catheter is held in place while the ETT is withdrawn over it.
A new ETT is threaded over the catheter and advanced into the trachea.
The catheter is removed after confirming tube placement per local practice.

Many Airway exchange catheter products include depth markings to help estimate insertion depth. Some include a central lumen and adapters to connect to oxygen sources or capnography sampling, but these features are not universal.

What the device is not

It helps learners to be explicit about boundaries:

Not a definitive airway: Airway exchange catheter does not provide the same protection against aspiration that a cuffed ETT provides.
Not a ventilator circuit: While some models allow oxygen delivery, they typically do not provide full ventilation in the way a standard ventilator circuit does.
Not interchangeable with a bougie: An intubation bougie is primarily an introducer for placing an ETT during intubation. Airway exchange catheter is designed for tube exchange and airway access maintenance, and may have different stiffness, length, lumen, and connectors.

Common design features (varies by manufacturer)

Understanding the physical components helps both clinical users and procurement teams evaluate fit-for-purpose:

Diameter and length: Commonly described in French (Fr) size and centimeters. Size selection must consider airway anatomy and compatibility with the ETT internal diameter.
Stiffness profile: Many are semi-rigid to support railroading; excessive stiffness can increase trauma risk.
Atraumatic distal tip: Often rounded or soft to reduce mucosal injury risk.
Depth markings: Help estimate position; must be interpreted carefully and correlated with technique.
Radiopaque element: Some have a radiopaque line to support imaging visibility (varies by manufacturer).
Central lumen: May allow oxygen insufflation and/or EtCO2 sampling; lumen size and connector type vary.
Proximal connectors/adapters: May include 15 mm connectors, Luer-style ports, or manufacturer-specific adapters. Misconnection risk is a real human-factors concern.

How medical students learn and encounter it in training

Medical students and trainees usually meet Airway exchange catheter in three ways:

Simulation and skills labs: Often introduced as part of difficult airway training, extubation planning, and crisis resource management.
Anesthesia rotation: Observing planned tube exchanges (for example, when a tube is damaged or malpositioned) and learning device selection and depth marking interpretation.
ICU exposure: Learning why extubation failure matters, how airway edema or secretion burden increases risk, and why maintaining airway access can be operationally important.

For residents and fellows, the device also becomes a team leadership tool: it forces a conversation about backup plans, escalation thresholds, and post-procedure monitoring.

When should I use Airway exchange catheter (and when should I not)?

Appropriate use cases (general)

Use cases vary by specialty and local protocol, but Airway exchange catheter is commonly considered in situations such as:

Endotracheal tube exchange when airway access is already established:
Examples include suspected cuff leak, a tube that is too small/large for management goals, a tube that is kinked or obstructed, or a tube requiring repositioning.
Planned exchange to a different tube type:
For instance, changing to a tube with different features (availability and clinical rationale vary by facility).
High-risk extubation strategy (“bridge” for possible re-intubation):
In selected patients where re-intubation might be difficult, the catheter may be left in place for a limited period after extubation, per protocol, to preserve access if deterioration occurs.
Airway management in settings where airway loss would be operationally catastrophic:
This includes limited staffing environments, transport, or locations distant from immediate airway backup, where a structured approach is prioritized.

These are general concepts, not a prescription. Patient selection and technique require supervision and institutional policy.

Situations where it may not be suitable

Airway exchange catheter is not universally appropriate, and in some cases it may add risk rather than reduce it. Situations where it may be unsuitable include:

When the airway is not secured and immediate definitive airway management is required:
If the patient cannot maintain oxygenation/ventilation and the current airway is failing, teams may prioritize definitive rescue strategies per local emergency algorithms.
When anatomical or pathological factors increase trauma risk:
Severe airway friability, known or suspected tracheal injury, or certain airway stenoses may make catheter placement hazardous. Contraindications vary by manufacturer and clinical scenario.
When patient cooperation and tolerance are not achievable (context-specific):
Some uses (such as leaving a catheter in place after extubation) may be poorly tolerated without appropriate sedation strategies and monitoring, which are clinical decisions.
Pediatric or small-airway scenarios without appropriate device sizes and expertise:
Device sizing and safety margins are different in children; product options and training vary.
When appropriate monitoring and backup equipment are not immediately available:
If the team cannot monitor oxygenation and ventilation effectively, or cannot rapidly re-establish a definitive airway if needed, the risk profile changes.

Safety cautions and contraindications (general, non-exhaustive)

Potential risks associated with Airway exchange catheter include:

Airway trauma: Mucosal injury, bleeding, or swelling from insertion or tube railroading.
Misplacement: The catheter may sit too shallow (loss of access) or too deep (potential endobronchial positioning).
Perforation and barotrauma risk: Particularly when oxygen insufflation or jet ventilation is attempted through a small lumen without adequate exhalation pathway.
Obstruction of exhalation: Any technique that introduces gas into the airway must account for a path for exhalation; occlusion can increase pressure.
Device migration or dislodgement: Especially if left in place after extubation; accidental withdrawal can eliminate the intended safety benefit.
Human factors and misconnections: Adapters and ports can be misunderstood, and Luer-style ports can create wrong-route connection risk.

Contraindications and warnings are manufacturer-specific and must be checked in the IFU. Facility policies may also restrict oxygen insufflation or jet ventilation through an Airway exchange catheter to certain credentialed staff.

Emphasize judgment, supervision, and local protocols

Because the device sits in a high-risk pathway (airway management), its safety depends heavily on:

Training and supervision.
Selection of an appropriate catheter size and technique.
Availability of backup airway equipment and skilled help.
Monitoring and escalation thresholds agreed upon by the team.

In most training environments, learners should expect to use Airway exchange catheter under direct supervision until competency is documented.

What do I need before starting?

Required setup and environment

Airway exchange catheter use should be planned like a procedure, even when it feels “simple.” A typical setup includes:

Standard monitoring: Pulse oximetry (SpO2), blood pressure, electrocardiography (ECG). Capnography (EtCO2) is often used when an ETT is in place; how it is maintained during exchange varies.
Oxygen and suction readiness: Wall oxygen source, working flowmeter, and suction with appropriate catheters.
Airway equipment immediately available:
A laryngoscope (video or direct), appropriately sized ETTs (including a backup size), syringe for cuff inflation, lubricant, tape or tube-securing device, and oral airways as needed per local practice.
A backup plan and rescue equipment:
This may include a bougie, supraglottic airway device, fiberoptic bronchoscope (if available), and equipment for emergency front-of-neck access per local emergency protocol.

Operationally, hospitals often store Airway exchange catheter on a difficult airway cart/trolley and/or in ICU airway kits to avoid delays.

Accessories and consumables (examples)

Depending on the model and the intended use, teams may need:

Compatible adapters for oxygen insufflation or EtCO2 sampling (varies by manufacturer).
A bite block if the catheter will remain in place while the patient is not deeply anesthetized (practice varies).
Securing tape or a fixation method to prevent migration.
Personal protective equipment (PPE), consistent with infection prevention policy.

Procurement teams should verify that accessory components are either included, consistently available, or standardized across departments to reduce last-minute improvisation.

Training and competency expectations

For clinicians and trainees, competency is more than “getting it in.” Many facilities expect training in:

Airway anatomy and safe depth estimation.
Tube exchange techniques and when to use additional visualization.
Oxygen insufflation or jet ventilation safety (if permitted in the facility).
Recognizing complications (bleeding, subcutaneous emphysema, pneumothorax suspicion, sudden desaturation).
Human-factors issues: labeling, connector identification, and “read-back” communication.

For administrators and educators, competency programs often include simulation, supervised cases, and documentation of privileges for high-risk adjuncts (such as jet ventilation), depending on local policy.

Pre-use checks and documentation

Even as a disposable clinical device, Airway exchange catheter needs basic pre-use checks:

Packaging integrity and sterility: Confirm the sterile barrier is intact.
Expiry date and storage conditions: Ensure stock rotation and that packaging hasn’t been compromised in storage.
Correct size and length for intended use: Must be compatible with the existing and planned ETT internal diameter.
Depth markings legibility: Markings should be visible and interpretable in the working environment.
Connector compatibility: Confirm adapters fit the oxygen source or sampling device intended. Misfit connectors are a predictable delay point.
Physical integrity: Check for kinks, cracks, or defects before insertion.

Documentation varies by facility, but commonly includes:

Indication for use (tube exchange, high-risk extubation strategy, etc.).
Device size/length and insertion depth.
Whether oxygen insufflation or EtCO2 sampling was used.
Any complications or unexpected events.
Lot number or identifier for traceability (particularly if an incident occurs).

Operational prerequisites (commissioning, maintenance readiness, policies)

Although Airway exchange catheter is often single-use and does not require “maintenance” like powered hospital equipment, the system around it does:

Commissioning and evaluation: New product introduction typically includes user evaluation, compatibility checks with local ETT brands/sizes, and clinical governance review.
Maintenance readiness: Biomedical engineering may not service the catheter itself, but may support the oxygen regulators, jet ventilators (if used), capnography modules, and suction systems that interact with it.
Consumables availability: Stock levels, reorder points, and emergency caches should match surgical and ICU demand.
Policies and procedures: Clear guidance on who can use the device, where it is stored, and what monitoring is required reduces variability and risk.
Incident management: Define how device-related issues are escalated (clinical incident report, biomedical evaluation, supplier notification).

Roles and responsibilities (clinician vs. biomedical engineering vs. procurement)

A reliable Airway exchange catheter workflow depends on aligned roles:

Clinicians (anesthesia, ICU, ED, respiratory therapy where applicable): Indication selection, technique, monitoring, and clinical documentation.
Nursing staff: Preparation, assistance, monitoring, and ensuring traceability details are captured.
Biomedical engineering / clinical engineering: Readiness of related hospital equipment (oxygen delivery, jet ventilators if used, monitors), evaluation of device failures, and support for recalls or field safety notices.
Procurement and supply chain: Product standardization, vendor qualification, contract management, stock continuity, and ensuring the right mix of sizes.
Infection prevention: Policies on single-use devices, disposal streams, and handling of reusable accessories.

How do I use it correctly (basic operation)?

Workflows vary by manufacturer, local protocol, and clinical context. The steps below describe a commonly taught structure for safe use and team coordination. They are not a substitute for supervised training or the manufacturer’s IFU.

Basic workflow: exchanging an endotracheal tube over Airway exchange catheter

Plan the exchange and brief the team.
Agree on roles (operator, assistant, monitoring), the reason for exchange, and the backup plan if the exchange fails.
Ensure monitoring and readiness.
Confirm SpO2 monitoring, blood pressure cycling, suction readiness, and immediate availability of backup airway equipment.
Select the catheter size and confirm tube compatibility.
The planned new ETT must be able to pass over the catheter. Compatibility depends on the catheter’s external diameter and the ETT internal diameter.
Prepare the device.
Keep the catheter sterile, confirm depth markings, and prepare any adapters you may need (oxygen or EtCO2 sampling), if used in your facility.
Insert Airway exchange catheter through the existing ETT.
Advance gently to a depth consistent with local practice and the device markings. Do not force against resistance.
Stabilize and secure the catheter position.
One team member’s job is often to hold the catheter at a fixed depth to prevent migration during tube removal.
Remove the old ETT over the catheter.
The ETT is withdrawn while the catheter remains in the trachea. Care is taken to avoid pulling the catheter out with the tube.
Advance the new ETT over the catheter.
The new tube is guided along the catheter into the trachea. Some teams use visualization (direct or video laryngoscopy, or fiberoptic guidance) depending on local protocol and risk assessment.
Confirm airway placement per local standards.
Common confirmation methods include capnography, chest rise, auscultation, and ventilator waveforms once connected. Confirmation workflows vary by institution.
Remove the catheter once the new tube is secured.
After the new ETT is confirmed and stabilized, the catheter is withdrawn, and the ETT is secured.
Document the procedure.
Record device size, depth, confirmation method, and any complications or deviations.

Basic workflow: using Airway exchange catheter as a “bridge” after extubation (high-level concept)

In some protocols, Airway exchange catheter may be placed before extubation and left in place briefly after the ETT is removed to maintain a path for possible re-intubation. This use case is highly dependent on patient selection, staff training, monitoring capacity, and institutional policy.

A generalized sequence is:

Place the catheter through the ETT.
Remove the ETT while stabilizing the catheter.
Maintain continuous monitoring and a clearly defined time window and removal plan per protocol.
If the patient deteriorates and re-intubation is needed, a tube may be advanced back over the catheter under appropriate supervision and technique.

This strategy can create new risks (migration, intolerance, trauma), so facilities often define strict criteria and supervision requirements.

Setup notes: “calibration” and equipment interfaces

Airway exchange catheter itself typically does not require calibration. However, interfaces may:

Oxygen insufflation: If used, oxygen delivery is set on a flowmeter or regulated device. Exact flow targets and duration should follow the IFU and local protocol.
Jet ventilation (if applicable): Some models and clinical settings allow high-pressure oxygen delivery through dedicated jet ventilation equipment. This requires specific training and strict risk controls, because inadequate exhalation can lead to dangerous pressure buildup. Settings, connectors, and technique vary by manufacturer and facility.

Hospitals should avoid informal improvisation (for example, connecting unfamiliar adapters without training), because misconnections and pressure-related complications are well described hazards in airway care.

Typical “settings” and what they mean (conceptual)

Because settings are device- and protocol-dependent, it is safer to think in concepts rather than numbers:

Oxygen flow (low vs. higher): Higher flow may increase oxygen delivery but can also increase pressure risk if exhalation is limited.
Jet pressure and inspiratory timing: Higher pressure and longer inspiratory times can increase risk if gas cannot escape. Adequate exhalation time and an open exhalation pathway are key principles.
Capnography sampling: Sampling through a narrow lumen may produce a delayed or dampened EtCO2 waveform. Interpretation should account for this limitation.

If your facility uses oxygen insufflation or jet ventilation through Airway exchange catheter, the safest operational approach is to standardize equipment, connectors, training, and supervision rather than relying on ad hoc practice.

Commonly universal “do’s” across models

Even though product details vary, these are widely applicable practices:

Use gentle advancement; never force against resistance.
Maintain continuous, assigned stabilization of catheter depth during tube removal.
Confirm compatibility between catheter size and ETT internal diameter before starting.
Keep a backup plan ready, including alternative airway devices and skilled help.
Treat the exchange as a procedure with documentation and post-event monitoring.

How do I keep the patient safe?

Safety with Airway exchange catheter is less about the catheter itself and more about the system: patient selection, team preparation, monitoring, and disciplined technique. The following are general safety practices that many facilities build into protocols.

Core safety practices and monitoring

Continuous oxygenation monitoring: Pulse oximetry (SpO2) is essential, recognizing that SpO2 can lag behind ventilation problems, especially if supplemental oxygen is used.
Ventilation monitoring: Capnography (EtCO2) is commonly used when an ETT is connected to a circuit. During exchange, EtCO2 monitoring may be interrupted or adapted depending on equipment and local workflow.
Hemodynamic monitoring: Blood pressure and heart rate changes can signal distress, especially in critically ill patients.
Direct observation: Chest rise, breath sounds, and patient response remain important, especially when waveform monitoring is transiently unavailable.

Safety also depends on minimizing time without a definitive airway and avoiding unnecessary repeated attempts that can cause swelling or bleeding.

Depth control and airway trauma prevention

Device-related harm often comes from a small number of predictable issues:

Too deep insertion: Can lead to endobronchial positioning and trauma. Depth markings help, but should not replace clinical judgment and local technique.
Too shallow insertion: Increases the risk that the catheter will dislodge during tube removal.
Forcing against resistance: Resistance may reflect anatomy, tube kinking, secretions, or misalignment. Forcing can cause mucosal injury or worse.

Facilities may teach “stop points” where the team pauses if resistance or instability is encountered. Exact thresholds and responses should be defined by protocol.

Oxygen insufflation and jet ventilation: risk-aware framing

Some Airway exchange catheter models support oxygen insufflation and/or jet ventilation. These features can be useful in select settings but carry specific risks:

Pressure-related complications: Introducing gas into a small-lumen catheter can increase airway pressure, especially if exhalation is limited (e.g., upper airway obstruction, laryngospasm, biting, or mucus plugging).
CO2 clearance limitations: Oxygen delivery does not guarantee carbon dioxide removal; ventilation and oxygenation are different physiological goals.
Equipment and training dependence: Safe use requires correct connectors, pressure regulation, monitoring, and trained staff.

Hospitals often restrict high-pressure oxygen delivery to credentialed clinicians and specific contexts, with explicit monitoring and emergency response steps.

Alarm handling and human factors

Many adverse events are “system” events—miscommunication, misconnection, and workflow drift—rather than purely technical failures.

Practical controls include:

Connector discipline: Identify which port is for oxygen, which (if any) is for EtCO2 sampling, and which adapters are approved. Avoid mixing with IV tubing and Luer connections where wrong-route connections could occur.
Labeling and visual cues: Some facilities label adapter sets or store them as a bundled kit to reduce selection errors during emergencies.
Role assignment: One person should be responsible for stabilizing catheter depth; one for monitoring; one for tube handling. This reduces task overload.
Closed-loop communication: Read back critical steps (e.g., “catheter held at X marking,” “tube cuff deflated,” “old tube out,” “new tube connected”).

Risk controls beyond the bedside

Administrators and safety leaders can reduce risk by building guardrails:

Standardize device options: Fewer product variants reduce compatibility surprises (connectors, depth markings, stiffness).
Create a documented protocol: Include indications, contraindications, required monitoring, documentation fields, and escalation pathways.
Use simulation: Practice the exchange in a low-stakes environment, including troubleshooting and communication.
Build an incident reporting culture: Encourage reporting of near misses (e.g., wrong connector selected, catheter dislodged without harm) to strengthen system learning.
Review device labeling and IFU: Ensure staff know where to find IFUs, and that packaging is clear in high-stress situations.

How do I interpret the output?

Airway exchange catheter is primarily a mechanical clinical device; it does not typically produce a digital “output” like a monitor. In practice, “output” refers to the information clinicians gather from the device’s physical cues and any connected monitoring (oxygen flow, pressure gauges, EtCO2 sampling, patient monitors).

Types of outputs/readings you might encounter

Depth markings (centimeters): Visual markers used to estimate insertion depth.
Tactile feedback: Perceived resistance during insertion or during tube advancement over the catheter.
Capnography signal (EtCO2), if sampled through the lumen: A waveform and numeric value may be available depending on adapters and sampling method.
Oxygen flow or pressure displays: If oxygen insufflation or jet ventilation is used, flowmeters and pressure regulators provide numeric outputs.
Patient monitor trends: SpO2, respiratory rate (if available), heart rate, and blood pressure are indirect but critical “outputs” that reflect how well the exchange is tolerated.

How clinicians typically interpret them (general approach)

Depth markings: Used to keep the catheter in a consistent position and to communicate position between team members (“holding at X cm”). Markings are guides, not guarantees of correct placement.
Tactile feedback: Smooth passage is reassuring; resistance prompts reassessment. Resistance alone does not diagnose the problem (it could be anatomy, secretions, device kink, or technique).
EtCO2 sampling: A consistent waveform can support the idea that the catheter lumen is sampling exhaled gas, which may help confirm airway continuity. Absence of a waveform is not definitive proof of misplacement because sampling can fail due to secretions, low flow, disconnections, or equipment limitations.
SpO2 trends: A falling SpO2 is a late sign in some oxygenated patients; clinicians interpret it in context with ventilation, perfusion, and the time course.

Common pitfalls and limitations

Misreading depth: Markings can be obscured by secretions, tape, or poor lighting. Teams can also confuse catheter markings with ETT markings.
Delayed/dampened capnography: Sampling through a narrow lumen may change waveform quality. Secretions can block the lumen and create false reassurance or false concern.
Overreliance on oxygenation: SpO2 can remain acceptable while ventilation fails, especially if high inspired oxygen is used.
Assuming the catheter equals a secure airway: The catheter does not seal the airway like a cuffed tube and does not prevent aspiration.

The safest interpretation approach is multi-modal: correlate catheter depth, clinical signs, and monitor data rather than relying on any single signal.

What if something goes wrong?

Airway exchanges can fail for predictable reasons. A structured response reduces panic and helps the team switch rapidly to a safer alternative. The checklist below is a general troubleshooting framework; exact actions should follow local difficult airway protocols and supervision.

Troubleshooting checklist (common problems)

If Airway exchange catheter will not pass through the existing ETT:

Check if the ETT internal diameter is compatible with the catheter size.
Consider kinking, narrowing, or obstruction of the ETT (secretions, bite, tube defect).
Confirm that you are advancing gently and not against resistance.
Ensure lubrication and alignment; stop if resistance persists.

If the catheter passes, but the new ETT will not advance over it:

Confirm compatibility between catheter diameter and the new ETT internal diameter.
Check whether the new ETT bevel is catching at the larynx or tube tip is impinging (a known mechanical issue in some exchanges).
Consider whether additional visualization is needed (technique varies by facility).
Avoid repeated forceful attempts that can cause swelling or trauma.

If oxygenation or ventilation worsens during the exchange:

Pause the exchange and prioritize restoring oxygenation/ventilation per protocol.
Confirm that the airway is still accessible and that the catheter has not migrated.
Evaluate whether oxygen insufflation/jet ventilation (if used) could be contributing to pressure buildup.
Escalate early to senior help and backup airway plan.

If bleeding, significant coughing, or suspected airway trauma occurs:

Stop advancing and reassess.
Maintain situational awareness: trauma can rapidly worsen visualization and airway patency.
Follow local escalation pathways and document the event.

If the lumen seems blocked (no gas sampling, no oxygen flow, unusual resistance):

Suspect secretions, kinking, or connector issues.
Replace the device if integrity is in doubt, following sterile practice.

If connectors do not fit or appear unsafe:

Do not improvise connections under pressure.
Use only manufacturer-provided or facility-approved adapters.
Escalate to biomedical engineering or supply chain if repeated incompatibilities occur.

When to stop use

In general, teams consider stopping an exchange attempt and switching strategies when:

Resistance is significant or worsening.
The patient becomes unstable (oxygenation, ventilation, hemodynamics).
There is concern for misplacement or injury.
Equipment does not function as expected or connectors are uncertain.

The safest “stop” decision is often early—before repeated attempts increase swelling, bleeding, and risk.

When to escalate to biomedical engineering or the manufacturer

Escalation is appropriate when the issue is likely device- or system-related rather than patient-related, for example:

Packaging defects or compromised sterile barrier found on opening.
Connector mismatch with approved equipment despite correct selection.
Suspected manufacturing defect (kink at rest, lumen occlusion, abnormal stiffness).
Recurring failures associated with a particular lot or batch (if identifiable).
Jet ventilation equipment malfunction, regulator problems, or monitor interface issues.

Biomedical engineering can help evaluate related hospital equipment, document device failures, and support corrective actions with procurement and suppliers.

Documentation and safety reporting expectations (general)

For hospitals, the “after-action” phase is part of safety:

Document what happened, including device identifiers and lot numbers where available.
File internal incident reports for adverse events and near misses.
Preserve the device and packaging when policy requires investigation.
Feed learnings into education, stocking decisions, and protocol updates.

A consistent reporting culture allows organizations to see patterns (e.g., repeated connector confusion) before a serious injury occurs.

Infection control and cleaning of Airway exchange catheter

Infection prevention for Airway exchange catheter is primarily about aseptic handling, correct single-use disposal, and appropriate cleaning of any reusable accessories or adjacent hospital equipment.

Cleaning principles

Maintain aseptic technique at opening and use: The device is typically supplied sterile; contamination can occur during handling.
Minimize environmental exposure: Prepare the exchange area, organize equipment, and avoid placing sterile items on non-sterile surfaces.
Use appropriate PPE: Gloves, eye protection, and additional PPE per facility policy, especially in high-risk respiratory infection contexts.

Disinfection vs. sterilization (general concepts)

Sterilization: A process intended to eliminate all forms of microbial life. Many Airway exchange catheter products are supplied sterile and intended for single use.
Disinfection: Reduces microbial load; levels vary (low, intermediate, high-level). Disinfection is more relevant for reusable accessories (e.g., certain connectors) and nearby equipment.

Whether any component is reusable is strictly “Varies by manufacturer.” If the IFU states single-use, the safest and most compliant approach is disposal after one patient use.

High-touch points and adjacent equipment

Even when the catheter is disposable, other surfaces become contaminated during airway procedures:

Proximal connectors and adapters used for oxygen or sampling.
Oxygen tubing and flowmeter knobs touched with gloved hands.
Suction canister and tubing.
Laryngoscope handles, video laryngoscope screens, and cables.
Bed rails, ventilator touchscreens, and monitor controls.

In busy clinical areas, these high-touch points are common sources of cross-contamination if cleaning responsibilities are unclear.

Example cleaning and disposal workflow (non-brand-specific)

Before use:
Confirm the package is intact and within expiry; prepare a clean work area and assemble needed equipment to minimize searching mid-procedure.
During use:
Maintain clean/sterile technique for the catheter; avoid laying the device on non-sterile surfaces. Manage secretions with suction to reduce contamination spread.
After use (single-use device):
Dispose of the catheter immediately into appropriate clinical waste/biohazard stream per policy.
After use (reusable accessories and adjacent equipment):
Wipe and disinfect external surfaces according to the equipment’s cleaning instructions and the facility’s approved disinfectant list. Send reusable airway instruments to central sterile services as required.
Documentation:
Record any breach in sterility, unusual contamination event, or supply integrity issue.

Follow the IFU and facility infection prevention policy

The manufacturer’s IFU defines whether the device is single-use, how it is packaged, and what (if any) reprocessing is permitted. Facility infection prevention policy defines:

Approved disinfectants.
Contact times.
PPE requirements.
Waste streams and sharps handling rules.
Responsibilities (who cleans what, and when).

Aligning IFU requirements with real-world workflows is an operations task as much as a clinical one.

Medical Device Companies & OEMs

Manufacturer vs. OEM (Original Equipment Manufacturer)

In healthcare supply chains, the company name on the box may not always be the entity that physically manufactures every component.

Manufacturer (brand owner): The company responsible for marketing, distribution, quality systems, and post-market support under its brand name.
OEM: A company that manufactures a product (or component) that is then sold under another company’s brand (sometimes called “private label” or “contract manufacturing”).

OEM relationships can impact:

Quality consistency: Strong quality agreements and audits matter, especially for sterile disposables.
Change control: Material or process changes may occur upstream; robust notification pathways help hospitals manage risk.
Support and recalls: The brand owner usually communicates with customers, but upstream OEM investigations may drive corrective actions.
Supply continuity: Multi-site manufacturing or diversified OEM sourcing can reduce disruption risk, but details are not always publicly stated.

For procurement and biomedical engineering teams, the practical question is not only “Who sells it?” but also “Who stands behind the quality system, traceability, and field support?”

Top 5 World Best Medical Device Companies / Manufacturers

The following are example industry leaders (not a ranking) commonly recognized for broad medical device portfolios and global hospital presence. Whether a specific Airway exchange catheter model is offered, and in which markets, varies by manufacturer.

Medtronic
Medtronic is widely known for a large portfolio spanning surgical, cardiovascular, and critical care technologies. In many regions, the company participates in airway and ventilation-adjacent categories through various product lines. Global footprint and local availability depend on country-specific operations and distribution models.
Teleflex
Teleflex is often associated with anesthesia and critical care disposables, vascular access, and airway management categories. Many hospitals encounter Teleflex products in OR and ICU supply chains where standardization matters. Exact product availability and configurations can differ by region and tender structures.
B. Braun
B. Braun has a broad hospital equipment and medical consumables presence, including infusion therapy, surgery, and infection prevention-related categories. In many countries, B. Braun’s footprint is supported by established hospital supply and training infrastructure. Airway-specific offerings and market presence vary across regions.
Cook Medical
Cook Medical is known for interventional and specialty medical devices across multiple clinical areas. Hospitals may encounter Cook products through procedural suites and specialty services where device selection is more customized. Specific airway exchange offerings, sizes, and distribution vary by country and product line.
ICU Medical (including legacy Smiths Medical portfolios in some markets)
ICU Medical is recognized for infusion and critical care products, and in some markets its portfolio includes devices used in airway and ICU workflows. Hospital familiarity often comes through high-utilization ICU consumables and standardization programs. Portfolio composition and branding can vary by region and over time.

When evaluating a specific Airway exchange catheter, hospitals typically request product samples, IFUs, compatibility checks with local ETT brands, and supplier quality documentation rather than relying on brand reputation alone.

Vendors, Suppliers, and Distributors

Role differences: vendor vs. supplier vs. distributor

These terms are often used interchangeably, but they can imply different functions in the medical equipment ecosystem:

Vendor: The entity that sells to the hospital (may be a manufacturer, distributor, or reseller). Vendors usually manage pricing, contracts, and customer service.
Supplier: A broader term that can include manufacturers, wholesalers, and companies providing goods or services to the hospital.
Distributor: A company focused on warehousing, logistics, order fulfillment, and sometimes value-added services such as kitting, inventory management, and returns processing.

In many countries, hospitals buy Airway exchange catheter through layered supply chains: manufacturer → regional distributor → hospital, or through centralized tenders and group purchasing mechanisms.

Top 5 World Best Vendors / Suppliers / Distributors

The following are example global distributors (not a ranking) that are commonly referenced in hospital supply chain contexts. Exact geographic reach, service levels, and product categories differ by country and are often shaped by local subsidiaries and partnerships.

McKesson
McKesson is widely recognized for large-scale healthcare distribution and supply chain services in markets where it operates. Its value proposition often includes logistics scale, contract management support, and integration with hospital purchasing workflows. International reach and product scope vary by region.
Cardinal Health
Cardinal Health is known for distribution services and a broad range of hospital consumables categories in certain markets. Many hospitals interact with Cardinal Health through standardized supply programs, logistics services, and procurement support. Availability and service models depend on country-specific operations.
Medline Industries
Medline is often associated with medical-surgical supplies, procedure kits, and hospital consumables. In some regions, Medline supports hospitals with kitting and standardization initiatives that can simplify stocking of airway-related disposables. Its distribution footprint varies globally.
Henry Schein
Henry Schein is widely known for healthcare distribution, especially in dental and outpatient domains, with medical distribution presence in selected markets. For hospitals and ambulatory centers, Henry Schein may function as a vendor for a broad catalog of clinical supplies. Product breadth and hospital penetration vary by country.
DKSH
DKSH is known in parts of Asia and other regions for market expansion services, distribution, and logistics for healthcare products. Hospitals may encounter DKSH as a local distributor for multinational manufacturers, especially where local warehousing and regulatory support are needed. Exact country coverage and product portfolios vary.

For hospital procurement teams, distributor selection often hinges on delivery reliability, cold-chain needs (if any), complaint handling, recall responsiveness, and the ability to maintain consistent stock of multiple catheter sizes.

Global Market Snapshot by Country

India

Demand for Airway exchange catheter in India is tied to growth in surgical volumes, expanding ICU capacity in private and public sectors, and increased training in anesthesia and critical care. Import dependence can be significant for branded airway disposables, while local distribution networks are strong in major cities. Access and standardization are often better in tertiary urban hospitals than in smaller rural facilities.

China

China’s market is influenced by large hospital systems, high procedural volumes, and ongoing investment in critical care infrastructure in many provinces. Domestic manufacturing capabilities are extensive for many consumables, but procurement decisions may still favor imported devices in some premium segments. Distribution and service ecosystems are typically strongest in urban centers, with variability across regions.

United States

In the United States, Airway exchange catheter use is shaped by established anesthesia and ICU practices, mature difficult airway education, and strong emphasis on documentation and safety reporting. Purchasing is commonly driven by value analysis committees, group purchasing organizations, and standardization initiatives. Product availability is broad, with strong distributor infrastructure across acute care settings.

Indonesia

Indonesia’s demand is concentrated in larger urban hospitals where surgical and ICU services are more developed. Many facilities rely on imported airway disposables, making pricing and supply continuity important operational considerations. Outside major cities, access can be constrained by logistics and fewer trained providers for advanced airway adjuncts.

Pakistan

In Pakistan, demand is higher in tertiary care centers and private hospitals with surgical and ICU capacity. Import dependence and variability in distributor coverage can affect device availability and standardization. Training and protocol adoption may differ across institutions, influencing how consistently Airway exchange catheter is stocked and used.

Nigeria

Nigeria’s market is shaped by a mix of public and private hospital systems, with advanced airway adjunct use more common in better-resourced urban facilities. Import dependence and foreign exchange pressures can influence purchasing of disposable airway devices. Distribution and biomedical support are often uneven between cities and rural areas, affecting readiness and consistency.

Brazil

Brazil has a sizable healthcare system with strong tertiary centers and a meaningful private sector, supporting demand for airway management disposables and related training. Local regulatory and procurement pathways can add complexity to importing, so distributor capability matters. Urban centers tend to have better access to advanced airway tools than remote regions.

Bangladesh

Bangladesh’s demand is closely linked to expanding ICU services and surgical care in major cities. Many hospitals depend on imported airway consumables, and procurement may prioritize cost-effective standard options. Access outside metropolitan areas can be limited by staffing, training, and supply chain reach.

Russia

Russia’s market is influenced by large regional hospital networks and variable access across a wide geography. Import substitution policies and domestic production may affect availability of certain branded consumables, with actual product mix varying by region. Distribution and service can be robust in major cities but more challenging in remote areas.

Mexico

Mexico’s demand reflects growth in surgical services and critical care capacity, with purchasing patterns differing between public institutions and private hospital networks. Many airway disposables are imported, making distributor relationships important for continuity and training support. Urban hospitals typically have greater access to standardized airway carts and advanced adjuncts.

Ethiopia

In Ethiopia, demand is concentrated in larger referral hospitals and expanding urban centers. Import dependence and constrained budgets often shape device selection, with a focus on essential airway tools and reliable supply. Rural access challenges and workforce limitations can reduce routine availability of specialized disposables like Airway exchange catheter.

Japan

Japan’s market is supported by advanced anesthesia and critical care practice, strong hospital standards, and consistent training pathways. Procurement often emphasizes quality systems, reliable distribution, and compatibility with established workflows. Access is generally strong across urban and many regional hospitals, though product preferences may be highly standardized.

Philippines

The Philippines shows demand growth in private tertiary hospitals and major urban centers where ICU and surgical services are concentrated. Many airway disposables are imported, and continuity can depend on distributor performance and tender outcomes. Rural and island geography can create logistics challenges for consistent stocking of multiple device sizes.

Egypt

Egypt’s demand is driven by large public hospitals, growing private sector capacity, and increasing critical care needs. Import dependence is common for specialized airway consumables, with pricing and availability influenced by procurement mechanisms and distributor networks. Access and training depth may vary significantly between urban tertiary centers and smaller facilities.

Democratic Republic of the Congo

In the Democratic Republic of the Congo, demand for Airway exchange catheter is often limited to better-resourced urban hospitals and specialized centers. Supply chains can be fragile, and import dependence with variable distribution coverage affects availability. Workforce constraints and competing priorities can limit routine stocking of specialized airway adjuncts.

Vietnam

Vietnam’s market reflects rapid health system development, increasing surgical volumes, and expanding ICU capability in major cities. Many consumables are imported, but local manufacturing for some categories is growing, affecting purchasing strategies. Urban centers typically lead adoption of standardized airway tools, with rural areas facing more constraints.

Iran

Iran’s demand is influenced by strong clinical training in many tertiary centers and a need for reliable ICU and anesthesia supplies. Import restrictions and domestic manufacturing capacity can shape which brands and models are available. Distribution and service capability may vary, with larger cities generally better supported.

Turkey

Turkey has a diversified healthcare system with both public and private capacity, supporting steady demand for airway management consumables and related hospital equipment. Import and local production both play roles, and procurement may be centralized in larger systems. Urban tertiary hospitals typically drive standardization and advanced airway workflows.

Germany

Germany’s market is characterized by high procedural volume, strong clinical governance, and established procurement processes within hospital systems. Device selection often emphasizes documented quality, compatibility, and training support. Distribution is generally reliable, with broad access to airway management disposables across regions.

Thailand

Thailand’s demand is concentrated in Bangkok and other major cities where tertiary hospitals and private facilities have robust surgical and ICU services. Many airway disposables are imported, with purchasing influenced by tender processes and distributor support. Regional hospitals may have more limited access to specialized adjuncts and fewer standardized difficult airway resources.

Key Takeaways and Practical Checklist for Airway exchange catheter

Airway exchange catheter is designed to maintain tracheal access during endotracheal tube exchange or selected high-risk extubation strategies.
Treat Airway exchange catheter use as a procedure with planning, role assignment, and documentation.
Confirm the indication is appropriate and that local policy supports the intended use case.
Check the manufacturer’s IFU for device-specific warnings, connectors, and compatibility statements.
Select a catheter size that is compatible with both the current ETT and the planned replacement ETT.
Confirm the sterile package integrity and expiry date before opening.
Ensure SpO2 monitoring is continuous and visible to a dedicated team member.
Recognize that SpO2 may lag behind ventilation failure, especially if supplemental oxygen is used.
Keep suction ready and functioning before starting any exchange.
Prepare backup airway equipment before removing the existing ETT.
Brief the team on the primary plan and at least one clear backup plan.
Assign one person to stabilize catheter depth during tube removal and replacement.
Use depth markings as a communication tool, not as a guarantee of correct position.
Advance the catheter gently and stop if resistance is encountered.
Avoid repeated forceful attempts that can worsen swelling and bleeding.
Expect workflow differences across models; standardization reduces last-minute confusion.
If oxygen insufflation is used, ensure the connector is correct and approved by local policy.
Understand that oxygen delivery does not equal ventilation or CO2 clearance.
If jet ventilation is used, ensure trained staff, pressure regulation, and strict monitoring are in place.
Beware of pressure-related complications when delivering gas through a small lumen.
Prevent misconnections by storing approved adapters together and labeling where appropriate.
Maintain closed-loop communication during key steps (catheter in, tube out, tube in, confirmation).
Use multi-modal confirmation after exchange (clinical assessment plus monitoring per protocol).
Document catheter size, insertion depth, confirmation method, and any complications.
Capture lot number or identifier when policy requires traceability.
If the new ETT does not pass easily over the catheter, reassess compatibility and technique rather than forcing.
If oxygenation or ventilation worsens, pause and prioritize patient stabilization per protocol.
Escalate early to senior airway help when difficulty is encountered.
Do not improvise unfamiliar connectors under time pressure; use approved equipment only.
Treat device defects (kinks, lumen blockage, packaging issues) as reportable quality events.
Preserve the device and packaging for investigation if an incident occurs and policy requires it.
Encourage reporting of near misses to improve training, stocking, and protocol design.
Remember that Airway exchange catheter is usually single-use; reprocessing is “Varies by manufacturer” and must follow IFU.
Dispose of used devices in the correct clinical waste stream per infection prevention policy.
Clean high-touch adjacent equipment (flowmeters, monitors, laryngoscopes) after airway procedures.
Procurement teams should evaluate compatibility with local ETT inventory before standardizing a catheter model.
Stock multiple sizes in airway carts to support different patient needs and tube exchanges.
Biomedical engineering readiness focuses on supporting oxygen delivery equipment, monitors, and any jet ventilation devices used with the catheter.
Standard operating procedures should define who may use oxygen insufflation or jet ventilation through the catheter.
Training programs should include simulation of both routine exchanges and failure modes.
Post-event debriefs can identify system issues such as missing adapters, unclear roles, or stockouts.
Global availability, accessory sets, and labeling conventions vary by manufacturer and distributor.
Consistent supply chain performance is a safety issue when the device is needed urgently.
Build airway exchange workflows that are robust in both high-resource OR settings and resource-constrained units.

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