Larger endotracheal tube size in women increase the risk for ventilator-associated events

Abstract

Even though endotracheal tube (ETT) size selection is often the result of clinical judgement, factors such as age, gender, height, body mass index (BMI), and anticipated bronchoscopies are often considered before insertion. 1-3 The objective of this study was to explore whether gender differences exist in ventilator-associated event (VAE) development based on larger ETT selection. The surveillance paradigms for VAEs are established by the Centers for Disease Control and Prevention. 4 They denote 3 categories of increasing progression in mechanically ventilated patients from a ventilator-associated condition (VAC), to an infection-related ventilator-associated complication (IVAC), and finally to possible ventilator-associated pneumonia (PVAP). Our a priori hypothesis for this study was that an 8.0-mm ETT is associated with less risk of VAEs because a larger diameter is optimal for pulmonary hygiene. Methods

Endotracheal Tube Migration in Steep Trendelenburg Position With the Estape TrenMAX Positioning System

“…In addition to placing the ETT appropriately, anesthesiologists must also be aware of the physical forces and shifts that occur during surgery. The way the patient is positioned can greatly impact the process of ventilation [ 7 ]. One position of interest is the extreme Trendelenburg position, in which the patient lays supine at a 35-45 degree angle with their feet elevated above their head [ 8 ].…”

“…One position of interest is the extreme Trendelenburg position, in which the patient lays supine at a 35-45 degree angle with their feet elevated above their head [ 8 ]. The position is mostly used for urologic and gynecologic surgery, such as robotic-assisted prostatectomy [ 7 , 8 ]. The position itself is known to cause numerous complications, from ocular injury to soft tissue edema [ 8 ].…”