Are preformed endotracheal tubes appropriately designed for pediatric patients?

Hunyady, Ágnes; Jonmarker, Christer

doi:10.1111/pan.12691

Cited by 13 publications

(6 citation statements)

References 14 publications

(31 reference statements)

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“…In 2015, Hunyady AI et al reported that the bend-to-tip distance of preformed ETT differs from manufacturer to manufacturer, and particularly, a difference of up to 2 cm for a nasal tube with an ID of 7.0 mm. In 2001, Rolfe et al reported that discrepancies exist between manufacturers of preformed nasal tracheal tubes, leading to increased morbidity as a result of incorrect tube placement and repeat nasal intubation [ 2 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Oral endotracheal intubation interferes with the visual field and manipulation during surgery because most oral and maxillofacial surgeries are performed through the oral cavity. Therefore, in most cases, the airway is secured by nasotracheal intubation [ 1 2 ]. Because the nasal Ring-Adair-Elwyn (RAE) tubes undergo bending, the tube connector is faced upward when the tube is fixed, and there is less risk of blockage or twisting than when bending a typical tube.…”

Section: Introductionmentioning

confidence: 99%

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Air leakage due to the cuff hanging on the vocal cords during nasotracheal intubation: a case report

Ryoo

Karm

Park

et al. 2023

J Dent Anesth Pain Med

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Nasotracheal intubation is commonly performed under general anesthesia in oral and maxillofacial surgery. For the convenience of surgery, nasal Ring-Adair-Elwyn (RAE) tubes are mainly used. Because the nasal RAE tubes were bent in an “L” shape, the insertion depth was limited. Particularly, it is necessary to accurately determine the appropriate depth of the RAE tubes in children. Several types of nasal RAE tubes are used in the medical market, which vary in material and length. We performed endotracheal intubation using a nasal RAE tube for double-jaw surgery, but air leakage persisted even when the air pressure in the cuff was increased. When checked with a laryngoscope, it was confirmed that the tube was pushed out, and the cuff was caught on the vocal cords, causing air leakage. Since inserting the tube deeply did not solve the problem, replacing it with a nasal RAE tube (Polar™, Preformed Tracheal Tube, Smith Medical, Inc., USA) did not cause air leakage; thus, we reported this case.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Air leakage due to the cuff hanging on the vocal cords during nasotracheal intubation: a case report

Ryoo

Karm

Park

et al. 2023

J Dent Anesth Pain Med

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“…The cuffed tracheal tubes are useful for minimizing air leak during mechanical ventilation and for decreasing the potential polluting effect of anaesthetic gases . Correct placement of the cuff below the cricoid cartilage is important to avoid the risk of damage to the larynx . When a cuffed tube is inserted nasotracheally and the head is moved, there is a risk of damage to the vocal cords using the inflated cuff.…”

Section: Discussionmentioning

confidence: 99%

Changes in nasotracheal tube depth in response to head and neck movement in children

Yamanaka

Tsukamoto

Hitosugi

et al. 2018

Acta Anaesthesiol Scand

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“…Its bend should avoid the risk of kinking and ease of fixation. However, the fixed bend-to-tip distance (BT), which is specific for each ETT size, has the risk of malposition, [3][4][5] especially during the application of the Rose position or retractors. Bend-to-tip distance is crucial in choosing ETT size in each patient.…”

Section: Introductionmentioning

confidence: 99%

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

Tareerath

Mangmeesri

2021

Ear Nose Throat J

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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.

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Are preformed endotracheal tubes appropriately designed for pediatric patients?

Cited by 13 publications

References 14 publications

Air leakage due to the cuff hanging on the vocal cords during nasotracheal intubation: a case report

Air leakage due to the cuff hanging on the vocal cords during nasotracheal intubation: a case report

Changes in nasotracheal tube depth in response to head and neck movement in children

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

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