A Comparative Study of Tracheal Diameter in Caucasian and Chinese Patients

Tai, A.; Corke, C. F.; Joynt, Gavin M.; Griffith, James F.; Lunn, DP; Tong, Po-Yee

doi:10.1177/0310057x1604400603

Cited by 10 publications

(7 citation statements)

References 22 publications

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“…Considering the differences in the rate of endotracheal tube cuff pressure increase caused by tube size and tightness of air, we suggest that doctors and nurses should select normal or larger size for the tracheal tube when performing endotracheal intubation, but patients with tracheal stenosis have to be excluded. However, some researchers have pointed out that choosing a smaller size of the endotracheal tube may reduce the damage [ 33 , 34 ]. Therefore, further studies are needed to choose the suitable size of the endotracheal tube.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Cuff Pressure and Air Injection Volume of Endotracheal Tube: A Study with Sheep Trachea Ex Vivo

Qin

Zhou

Zhao

et al. 2022

Applied Bionics and Biomechanics

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Background. Endotracheal intubation is a widely used treatment. Excessive pressure of the endotracheal tube cuff leads to a series of complications. Here, we used tracheae of sheep to analyze the relationship between the air injection volume and endotracheal tube cuff pressure so as to guide the doctors and nurses in controlling the pressure of the endotracheal tube cuff during clinical work and minimise the risk of complications. Materials and Methods. Forty sheep tracheae were utilised and were divided into five groups according to their diameters. Different sizes of endotracheal tubes were inserted into each trachea, and the cuff pressure with the increase of air injection volume was recorded. The formulas that reflect the relationship between air injection volume and cuff pressure were obtained. Then, sheep tracheae were randomly selected; different types of tubes were inserted, and the stipulated volume of air was injected. The actual pressure was measured and compared with the pressure predicted from the formulas. Statistical analysis was conducted to verify whether the formulas obtained from the first part of the experiment were in accordance with the expert evaluation table, which consists of opinions of several experts. Results. After obtaining 15 formulas, we collected the differences between the theoretical cuff pressure and the actual cuff pressure that satisfied the expert evaluation. Relying on the formulas, the medical turntable was obtained, which is a tool that consists of two round cards with data on them. The top card has a notch. The two cards are stacked together, and as the top card rotates, the data on the bottom card can be easily seen in a one-to-one relationship. Conclusion. The formulas are capable of showing the relationship between the cuff air injection volume and pressure of endotracheal tube cuff. The medical turntable can estimate the air injection volume to ensure that the pressure stays in an acceptable range.

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Section: Discussionmentioning

confidence: 99%

The Relationship between Cuff Pressure and Air Injection Volume of Endotracheal Tube: A Study with Sheep Trachea Ex Vivo

Qin

Zhou

Zhao

et al. 2022

Applied Bionics and Biomechanics

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“…The ability to pass two 8.0 ETTs into the distal trachea was a surprising though welcome discovery. The average tracheal diameter for adult males is about 18–20 mm by radiographic imaging [ 11 , 12 ]. Two 8.0 ETTs have a total outer diameter of 22 mm when placed side by side.…”

Section: Discussionmentioning

confidence: 99%

Two Endotracheal Tubes in One Trachea with a Traumatic Injury

Winegarner

Lecamwasam

Kendall

et al. 2021

Case Reports in Anesthesiology

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Background. Traumatic airway injuries often require improvising solutions to altered anatomy under strict time constraints. We describe here the use of two endotracheal tubes simultaneously in the trachea to facilitate securing an airway which has been severely compromised by a self-inflicted wound to the trachea. Case Presentation: A 71-year-old male presented with a self-inflicted incision to his neck, cutting deep into the trachea itself. An endotracheal tube was emergently placed through the self-inflicted hole in the trachea in the ED. The patient was bleeding profusely, severely somnolent, and desaturating upon arrival to the operating room. Preservation of the tenuous airway was a priority while seeking to establish a more secure one. A video laryngoscope was used to gain a wide view of the posterior oropharynx and assist with oral intubation using a fiberoptic scope loaded with a second endotracheal tube. The initial tube’s cuff was deflated as the second tube was advanced over the fiberoptic scope, thereby securing the airway while a completion tracheostomy was performed. Conclusions. Direct penetrating airway trauma may necessitate early, albeit less secure, intubations though the neck wounds prior to operating room arrival. The conundrum is weighing the risk of losing a temporary airway while attempting to establish a more secure airway. Here, we demonstrate the versatility of common anesthesia tools such as a video laryngoscope and a fiberoptic bronchoscope and the welcome discovery of the trachea’s ability to accommodate two endotracheal tubes simultaneously so as to ensure a patent airway at all points throughout resuscitation.

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“…It is unclear if body mass index (BMI) has any effect, but if it does, it demonstrates an inverse correlation with tracheal size [15] and is an independent patient risk factor for subglottic stenosis following tracheostomy in critical care [16]. There is wide variation between populations of different ethnic backgrounds, but how this impacts on tracheal size when other variables such as height are taken into account is not clear [8,17].…”

Section: Discussionmentioning

confidence: 99%

Tracheal tube size in adults undergoing elective surgery – a narrative review

Karmali

Rose

2020

Anaesthesia

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Tracheal tubes are routinely used in adults undergoing elective surgery. The size of the tracheal tube, defined by its internal diameter, is often generically selected according to sex, with 7-7.5 mm and 8-8.5 mm tubes recommended in women and men, respectively. Tracheal diameter in adults is highly variable, being narrowest at the subglottis, and is affected by height and sex. The outer diameter of routinely used tracheal tubes may exceed these dimensions, traumatise the airway and increase the risk of postoperative sore throat and hoarseness. These complications disproportionately affect women and may be mitigated by using smaller tracheal tubes (6-6.5 mm). Patient safety concerns about using small tracheal tubes are based on critical care populations undergoing prolonged periods of tracheal intubation and not patients undergoing elective surgery. The internal diameter of the tube corresponds to its clinical utility. Tracheal tubes as small as 6.0 mm will accommodate routinely used intubation aids, suction devices and slim-line fibreoptic bronchoscopes. Positive pressure ventilation may be performed without increasing the risk of ventilator-induced lung injury or air trapping, even when high minute volumes are required. There is also no demonstrable increased risk of aspiration or cuff pressure damage when using smaller tracheal tubes. Small tracheal tubes may not be safe in all patients, such as those with high secretion loads and airflow limitation. A balanced view of risks and benefits should be taken appropriate to the clinical context, to select the smallest tracheal tube that permits safe perioperative management.

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A Comparative Study of Tracheal Diameter in Caucasian and Chinese Patients

Cited by 10 publications

References 22 publications

The Relationship between Cuff Pressure and Air Injection Volume of Endotracheal Tube: A Study with Sheep Trachea Ex Vivo

The Relationship between Cuff Pressure and Air Injection Volume of Endotracheal Tube: A Study with Sheep Trachea Ex Vivo

Two Endotracheal Tubes in One Trachea with a Traumatic Injury

Tracheal tube size in adults undergoing elective surgery – a narrative review

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