The supine-to-prone position change induces modification of endotracheal tube cuff pressure accompanied by tube displacement

The Tracheal Accordion and the Position of the Endotracheal Tube

“…It was found that in two out of 30 study patients (7%) with an ETView™ tracheoscopic ventilation tube (ETView TM , ETView Medical Ltd, Misgav, Israel) providing a continuous view of the carina and tube position within the trachea, a change from the supine to lithotomy position resulted in greater than 1 cm tube advancement such that the carina was no longer visualised (only this endpoint was reported) 9 . A change from the supine to the prone position in another study resulted in an increase in the ETTTip-CA distance of 0.59 ± 1.56 cm (P <0.05) 71 . Patients undergoing oral and maxillofacial surgery placed in neck extension had a 1.2 cm increase in ETTTip-CA distance that increased an additional 1.6 cm to 2.8 cm when a mouth gag was placed (no reported P value) 70 .…”

“…In addition to the position changes and interventions discussed, there are studies of changes in ETTTip-CA distances with changes to lithotomy and prone positions as well as with placement of a mouth gag and tongue blade 9,53,70,71 . It was found that in two out of 30 study patients (7%) with an ETView™ tracheoscopic ventilation tube (ETView TM , ETView Medical Ltd, Misgav, Israel) providing a continuous view of the carina and tube position within the trachea, a change from the supine to lithotomy position resulted in greater than 1 cm tube advancement such that the carina was no longer visualised (only this endpoint was reported) 9 .…”

Comparison of the endotracheal tube cuff pressure between a tapered- versus a cylindrical-shaped cuff after changing from the supine to the lateral flank position

“…In general, it is well known that various positional changes and head movements can displace the ETT tube in tracheally intubated patients. [11][12][13][14][15][16][17] Head extension can result in cephalad migration of the ETT, whereas head flexion can result in caudal displacement. 12,18 Lateral rotation of the head can cause movement of the ETT tip in both directions.…”

“…[7][8][9][10] Positional change and neck movement after intubation can displace an ETT in a patient's trachea. [11][12][13][14][15][16][17][18] Intratracheal migration of the ETT due to a change in patient positioning can result in a change in the ETT cuff pressure because the trachea is not cylindrical. [19][20][21][22] When the ETT migrates proximally toward the vocal cords, the cuff shape may be distorted and the intracuff volume may be compressed at a narrower and less compliant upper airway space such as at the level of the cricoid cartilage.…”

Cuff depth and continuous chest auscultation method for determination of tracheal tube insertion depth in nasal intubation: observational study

“…Furthermore, changes in neck and body posture may displace the tube, even if appropriate placement is confirmed by auscultation immediately after tube placement [3]. Therefore, it is necessary to determine accurately the positioning of the tracheal tube.…”