Esophageal tracheal airway/ Combitube®

Claas Siegmueller


This is an extraglottic device which is positioned inferior/ caudad to but outside the glottis.

The esophageal tracheal airway/ Combitube is one of several extraglottic airways currently being marketed. Other notable devices are the CobraPLA® and the COPA® (cuffed oropharyngeal airway).


The esophageal tracheal airway or Combitube is a double-lumen tube with two cuffs which has been around since 1987. It is supplied with two syringes which are already primed right out of the box to the correct inflation volume for each cuff of 12 ml and 85 ml respectively.

Esophageal tracheal airway/ Combitube® kit contents

Each lumen of the Combitube can be connected to a breathing system via a standard 15 mm tube connector and color-coded port.

The shorter white port is for the distal lumen, which opens just to the side of the atraumatic bevelled tip of the tube.

The longer blue port is for the proximal lumen, which opens between the two cuff through eight side holes.

Proximal lumen openings, pilot balloon, cuff and connector
Distal lumen opening, pilot balloon, cuf and connector

The esophageal tracheal airway is available in two sizes. The manufacturer recommends using the smaller 37 Fr device for patients under 5 feet (152 cm) height and the larger 41 Fr fsize for patients taller than that.

This device is not suited for use in pediatric patients.


The esophageal tracheal airway/ Combitube is a blind insertion airway device (as is the laryngeal mask). 

It is a popular piece of equipment in the emergency medicine and pre-hospital settings since placing it does therefore not require laryngoscopy skills or any additional equipment.


Ramaiah, Ramesh; Das, Debasmita; Bhananker, Sanjay M.; Joffe, Aaron M. (2014): Extraglottic airway devices: A review. In International journal of critical illness and injury science 4 (1), pp. 77–87. DOI: 10.4103/2229-5151.128019.

Brimacombe, Joseph (2004): A proposed classification system for extraglottic airway devices. In Anesthesiology 101 (2), p. 559. DOI: 10.1097/00000542-200408000-00054.

Akça, Ozan; Wadhwa, Anupama; Sengupta, Papiya; Durrani, Jaleel; Hanni, Keith; Wenke, Mary et al. (2004): The new perilaryngeal airway (CobraPLA) is as efficient as the laryngeal mask airway (LMA) but provides better airway sealing pressures. In Anesthesia and analgesia 99 (1), pp. 272–278. DOI: 10.1213/01.ane.0000117003.60213.e9.

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