In patients who have undergone a difficult intubation, extubation can also be present significant risks [1]. In these situations many experts recommend the use of airway exchange catheters [2, 3]. These hollow polyvinyl chloride ventilating catheters can be inserted through a tracheal tube at the conclusion of surgery and left in situ when the tracheal tube is removed. Should extubation fail, these catheters provide a ready means of re-intubating the trachea. The airway exchange catheter available in the UK is made by Cook Medical (William Cook Europe, Bjaeverskov, Denmark). Most literature describes the use of smaller diameter catheters (8 and 11 Fr.) [2].
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