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Patency of paediatric endotracheal tubes for airway instrumentation
Author(s) -
Elfgen J.,
Buehler P. K.,
Thomas J.,
Kemper M.,
Imach S.,
Weiss M.
Publication year - 2017
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12828
Subject(s) - medicine , intubation , endotracheal tube , endotracheal intubation , airway , anesthesia
Background Airway exchange catheters ( AEC ) and fiberoptic bronchoscopes ( FOB ) for tracheal intubation are selected so that there is only a minimal gap between their outer and inner diameter of endotracheal tube ( ETT ) to minimize the risk of impingement during airway instrumentation. This study aimed to test the ease of passage of FOB s and AEC s through paediatric ETT of different sizes and from different manufacturers when using current recommendations for dimensional equipment compatibility taken from text books and manufacturers information. Methods Twelve different brands of cuffed and uncuffed ETT sized ID 2.5 to 5.0 mm were evaluated in an in vitro set‐up. Ease of device passage as well as the locations of an impaired passage within the ETT were assessed. Redundant samples were used for same sized ETT and all measurements were triple‐checked in randomized order. Results In total, 51 paired samples of uncuffed as well as cuffed paediatric ETT were tested. There were substantial differences in the ease of ETT passage concordantly for FOB s and AEC s among different manufacturers, but also among the product lines from the same manufacturer for a given ID size. Restriction to passage most frequently was found near the endotracheal tube tip or as a gradually increasing resistance along the ETT shaft. Conclusions Current recommendations for dimensional equipment compatibility AEC s and FOB s with ETT s do not appear to be completely accurate for all ETT brands available. We recommend that specific equipment combinations always must be tested carefully together before attempting to use them in a patient.