Cuffed endotracheal tubes in children: the effect of the size of the cuffed endotracheal tube on intracuff pressure

2017 ◽  
Vol 27 (5) ◽  
pp. 494-500 ◽  
Author(s):  
Senthil G. Krishna ◽  
Mumin Hakim ◽  
Roby Sebastian ◽  
Heather L. Dellinger ◽  
Dmitry Tumin ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Intracuff Pressure ◽  
Endotracheal Tubes ◽  
Cuffed Endotracheal Tube

scholarly journals Effectiveness and safety of endotracheal tube cuffs filled with air versus filled with alkalinized lidocaine: a randomized clinical trial

2007 ◽  
Vol 125 (6) ◽  
pp. 322-328 ◽  
Author(s):  
Lais Helena Camacho Navarro ◽  
José Reinaldo Cerqueira Braz ◽  
Giane Nakamura ◽  
Rodrigo Moreira e Lima ◽  
Fredson de Paula e Silva ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Sore Throat ◽  
Cuff Pressure ◽  
Systolic Arterial Pressure ◽  
Tracheal Extubation ◽  
Prospective Clinical Study ◽  
Intracuff Pressure ◽  
Endotracheal Tubes ◽  
Oxide Anesthesia ◽  
De Medicina

CONTEXT AND OBJECTIVE: High intracuff pressure in endotracheal tubes (ETs) may cause tracheal lesions. The aim of this study was to evaluate the effectiveness and safety of endotracheal tube cuffs filled with air or with alkalinized lidocaine. DESIGN AND SETTING: This was a prospective clinical study at the Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista. METHODS: Among 50 patients, ET cuff pressures were recorded before, 30, 60, 90 and 120 minutes after starting and upon ending nitrous oxide anesthesia. The patients were randomly allocated to two groups: Air, with ET cuff inflated with air to attain a cuff pressure of 20 cmH2O; and Lido, with ET cuff filled with 2% lidocaine plus 8.4% sodium bicarbonate to attain the same pressure. ET discomfort before tracheal extubation, and sore throat, hoarseness and coughing incidence were studied at the time of discharge from the post-anesthesia care unit, and sore throat and hoarseness were studied 24 hours after anesthesia. RESULTS: Pressures in Lido cuffs were significantly lower than in Air cuffs (p < 0.05). Tracheal complaints were similar for the two groups, except for lower ET discomfort and sore throat incidence after 24 hours and lower systolic arterial pressure at the time of extubation in the Lido group (p < 0.05). CONCLUSION: ET cuffs filled with alkalinized lidocaine prevented the occurrence of high cuff pressures during N2O anesthesia and reduced ET discomfort and postoperative sore throat incidence. Thus, alkalinized lidocaine-filled ET cuffs seem to be safer than conventional air-filled ET cuffs.

Cuffed endotracheal tubes in cats

2020 ◽  
Vol 25 (3) ◽  
pp. 1-3
Author(s):  
David Yates ◽  
Albert Holgate
Keyword(s):  
Endotracheal Tube ◽  
Gas Flow ◽  
Assisted Ventilation ◽  
Flow Rates ◽  
Endotracheal Tubes ◽  
Cuffed Endotracheal Tube ◽  
Volatile Agents

A cuffed endotracheal tube may improve the airway seal in anaesthetised feline patients, compared to use of an uncuffed tube. This may improve capnography and decrease theatre pollution with volatile agents. However, two significant risks are associated with the technique. First, over-inflation of the cuff could occur, with associated iatrogenic tracheal damage; this may be prevented by use of a cuff manometer for inflation. Second, as a result of the improved seal, barotrauma may be more likely with high gas flow rates and assisted ventilation.

Changes in intracuff pressure of a cuffed endotracheal tube during prolonged surgical procedures

2015 ◽  
Vol 79 (1) ◽  
pp. 76-79 ◽  
Author(s):  
Hiromi Kako ◽  
Anatoliy Goykhman ◽  
Archana S. Ramesh ◽  
Senthil G. Krishna ◽  
Joseph D. Tobias
Keyword(s):  
Endotracheal Tube ◽  
Surgical Procedures ◽  
Intracuff Pressure ◽  
Cuffed Endotracheal Tube

Changes in intracuff pressure of a cuffed endotracheal tube during surgery for congenital heart disease using cardiopulmonary bypass

2015 ◽  
Vol 25 (7) ◽  
pp. 705-710 ◽  
Author(s):  
Hiromi Kako ◽  
Omar Alkhatib ◽  
Senthil G. Krishna ◽  
Sarah Khan ◽  
Aymen Naguib ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiopulmonary Bypass ◽  
Endotracheal Tube ◽  
Congenital Heart ◽  
Intracuff Pressure ◽  
Cuffed Endotracheal Tube

scholarly journals Accuracy of Age-Based Formula to Predict the Size and Depth of Cuffed Oral Preformed Endotracheal Tubes in Children Undergoing Tonsillectomy

2021 ◽  
pp. 014556132098051
Author(s):  
Matula Tareerath ◽  
Peerachatra Mangmeesri
Keyword(s):  
Body Mass Index ◽  
Endotracheal Tube ◽  
Body Mass ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
The Body ◽  
Insertion Depth ◽  
Endotracheal Tubes ◽  
Endotracheal Tube Size ◽  
Actual Size

Objectives: To retrospectively investigate the reliability of the age-based formula, year/4 + 3.5 mm in predicting size and year/2 + 12 cm in predicting insertion depth of preformed endotracheal tubes in children and correlate these data with the body mass index. Patients and Methods: Patients were classified into 4 groups according to their nutritional status: thinness, normal weight, overweight, and obesity; we then retrospectively compared the actual size of endotracheal tube and insertion depth to the predicting age-based formula and to the respective bend-to-tip distance of the used preformed tubes. Results: Altogether, 300 patients were included. The actual endotracheal tube size corresponded with the Motoyama formula (64.7%, 90% CI: 60.0-69.1), except for thin patients, where the calculated size was too large (0.5 mm). The insertion depth could be predicted within the range of the bend-to-tip distance and age-based formula in 85.0% (90% CI: 81.3-88.0) of patients. Conclusion: Prediction of the size of cuffed preformed endotracheal tubes using the formula of Motoyama was accurate in most patients, except in thin patients (body mass index < −2 SD). The insertion depth of the tubes was mostly in the range of the age-based-formula to the bend-to-tip distance.

scholarly journals Effect of routine vs on-demand nebulization of acetylcysteine with salbutamol on accumulation of airway secretions in endotracheal tubes: substudy of a randomized clinical trial

2020 ◽  
Vol 8 (S1) ◽  
Author(s):  
Sophia van der Hoeven ◽  
◽  
Lorenzo Ball ◽  
Federico Constantino ◽  
David M. van Meenen ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Work Of Breathing ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Invasive Ventilation ◽  
Cross Sectional ◽  
Endotracheal Tubes ◽  
On Demand

Abstract Background Accumulated airway secretions in the endotracheal tube increase work of breathing and may favor airway colonization eventually leading to pneumonia. The aim of this preplanned substudy of the ‘Preventive Nebulization of Mucolytic Agents and Bronchodilating Drugs in Intubated and Ventilated Intensive Care Unit Patients trial’ (NEBULAE) was to compare the effect of routine vs on-demand nebulization of acetylcysteine with salbutamol on accumulation of secretions in endotracheal tubes in critically ill patients. Results In this single-center substudy of a national multicenter trial, patients were randomized to a strategy of routine nebulizations of acetylcysteine with salbutamol every 6 h until end of invasive ventilation, or to a strategy with on-demand nebulizations of acetylcysteine or salbutamol applied on strict clinical indications only. The primary endpoint, the maximum reduction in cross-sectional area (CSA) of the endotracheal tube was assessed with high-resolution computed tomography. Endotracheal tubes were collected from 72 patients, 36 from patients randomized to the routine nebulization strategy and 36 of patients randomized to the on-demand nebulization strategy. The maximum cross-sectional area (CSA) of the endotracheal tube was median 12 [6 to 15]% in tubes obtained from patients in the routine nebulization group, not different from median 9 [6 to 14]% in tubes obtained from patients in the on-demand nebulization group (P = 0.33). Conclusion In adult critically ill patients under invasive ventilation, routine nebulization of mucolytics and bronchodilators did not affect accumulation of airway secretions in the endotracheal tube. Trial registration Clinicaltrials.gov Identifier: NCT02159196

Prevention of Unintentional Esophageal Intubation

PEDIATRICS ◽  
1972 ◽  
Vol 49 (2) ◽  
pp. 313-313
Author(s):  
W. L. Niccum
Keyword(s):  
Endotracheal Tube ◽  
Young Patients ◽  
Similar Type ◽  
Esophageal Intubation ◽  
Endotracheal Tubes

I read with interest the experience of Stool, Johnson, and Rosenfeld in unintentionally introducing an endotracheal tube into the esophagus.1 I would like to relate that 15 years or so ago we had a similar type of problem with one of my young patients. We have solved the problem of unintentional esophageal intubation in a different and it seems to me a more simple way. Each one of our Foregger endotracheal tubes has on its proximal end approximately 6 in. of #3 black silk looped through a perforation on the tube.

scholarly journals Efficacy of Pressure Support in Compensating for Apparatus Work

1993 ◽  
Vol 21 (1) ◽  
pp. 67-71 ◽  
Author(s):  
A. D. Bersten ◽  
A. J. Rutten ◽  
A. E. Vedig
Keyword(s):  
Endotracheal Tube ◽  
Flow Rate ◽  
Pressure Support ◽  
Work Of Breathing ◽  
Inspiratory Flow ◽  
Inspiratory Flow Rate ◽  
Respiratory Muscle Fatigue ◽  
Tube Size ◽  
Endotracheal Tubes ◽  
Endotracheal Tube Size

Breathing through an endotracheal tube, connector, and ventilator demand valve imposes an added load on the respiratory muscles. As respiratory muscle fatigue is thought to be a frequent cause of ventilator dependence, we sought to examine the efficacy of five different ventilators in reducing this imposed work through the application of pressure support ventilation. Using a model of spontaneous breathing, we examined the apparatus work imposed by the Servo 900-C, Puritan Bennett 7200a, Engstrom Erica, Drager EV-A or Hamilton Veolar ventilators, a size 7.0 and 8.0 mm endotracheal tube, and inspiratory flow rates of 40 and 60 l/min. Pressure support of 0, 5, 10, 15, 20 and 30 cm H2O was tested at each experimental condition. Apparatus work was greater with increased inspiratory flow rate and decreased endotracheal tube size, and was lowest for the Servo 900-C and Puritan Bennett 7200a ventilators. Apparatus work fell in a curvilinear fashion when pressure support was applied, with no major difference noted between the five ventilators tested. At an inspiratory flow rate of 40 l/min, a pressure support of 5 and 8 cm H2O compensated for apparatus work through size 8.0 and 7.0 endotracheal tubes and the Servo 900-C and Puritan Bennett 7200a ventilators. However, the maximum negative pressure was greater for the Servo 900-C. The added work of breathing through endotracheal tubes and ventilator demand valves may be compensated for by the application of pressure support. The level of pressure support required depends on inspiratory flow rate, endotracheal tube size, and type of ventilator.

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