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Endotracheal Tube

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1. Laryngeal mask airway versus endotracheal tube for percutaneous dilatational tracheostomy in critically ill adults. Full Text available with Trip Pro

Laryngeal mask airway versus endotracheal tube for percutaneous dilatational tracheostomy in critically ill adults. Percutaneous dilatational tracheostomy (PDT) is one of the most common bedside surgical procedures performed in critically ill adults, on intensive care units (ICUs), who require long-term ventilation. PDT is associated with relevant life-threatening complications: Cuff rupture or accidental extubation may lead to hypoxia, aspiration or loss of airway. Puncture of the oesophagus (...) , or creating a false passage during dilatation or replacement of the tracheostomy tube, can lead to pneumothorax or emphysema. Wound infections may occur which can cause mediastinits, especially after creation of false passage or in early tracheotomized post-sternotomy patients after cardiac surgery. During the procedure, the patient's airway can be secured with an endotracheal tube (ETT) or a laryngeal mask airway (LMA). This is an updated version of the review first published in 2014.To assess the safety

2018 Cochrane

2. WITHDRAWN: Techniques to ascertain correct endotracheal tube placement in neonates. Full Text available with Trip Pro

WITHDRAWN: Techniques to ascertain correct endotracheal tube placement in neonates. The success rate of correct endotracheal tube (ETT) placement for junior medical staff is less than 50% and accidental oesophageal intubation is common. Rapid confirmation of correct tube placement is important because tube malposition is associated with serious adverse outcomes including hypoxaemia, death, pneumothorax and right upper lobe collapse.ETT position can be confirmed using chest radiography (...) , but this is often delayed; hence, a number of rapid point-of-care methods to confirm correct tube placement have been developed. Current neonatal resuscitation guidelines advise that correct ETT placement should be confirmed by the observation of clinical signs and the detection of exhaled carbon dioxide (CO2). Even though these devices are frequently used in the delivery room to assess tube placement, they can display false-negative results. Recently, newer techniques to assess correct tube placement have

2018 Cochrane

3. Confirmation of Endotracheal Tube Placement in the Pre-Hospital Setting: Clinical and Cost-Effectiveness and Guidelines

Confirmation of Endotracheal Tube Placement in the Pre-Hospital Setting: Clinical and Cost-Effectiveness and Guidelines Confirmation of Endotracheal Tube Placement in the Pre-Hospital Setting: Clinical and Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Confirmation of Endotracheal Tube Placement in the Pre-Hospital Setting: Clinical and Cost-Effectiveness and Guidelines Confirmation of Endotracheal Tube Placement in the Pre-Hospital Setting: Clinical and Cost (...) -Effectiveness and Guidelines Last updated: March 7, 2018 Project Number: RB1201-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the comparative clinical effectiveness of esophageal intubation detector devices versus capnography for the confirmation of endotracheal tube placement in the pre-hospital setting? What is the comparative cost-effectiveness of esophageal intubation detector devices versus capnography for the confirmation

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

4. The effect of adhesive tape versus endotracheal tube fastener in critically ill adults: the endotracheal tube securement (ETTS) randomized controlled trial. Full Text available with Trip Pro

The effect of adhesive tape versus endotracheal tube fastener in critically ill adults: the endotracheal tube securement (ETTS) randomized controlled trial. The optimal securement method of endotracheal tubes is unknown but should prevent dislodgement while minimizing complications. The use of an endotracheal tube fastener might reduce complications among critically ill adults undergoing endotracheal intubation.In this pragmatic, single-center, randomized trial, critically ill adults admitted (...) to the medical intensive care unit (MICU) and expected to require invasive mechanical ventilation for greater than 24 h were randomized to adhesive tape or endotracheal tube fastener at the time of intubation. The primary endpoint was a composite of any of the following: presence of lip ulcer, endotracheal tube dislodgement (defined as moving at least 2 cm), ventilator-associated pneumonia, or facial skin tears anytime between randomization and the earlier of death or 48 h after extubation. Secondary

2019 Critical care (London, England) Controlled trial quality: predicted high

5. Discrimination ability of the endotracheal tube location using real-time palpation during intubation using an endotracheal tube with a preloaded stylet Full Text available with Trip Pro

Discrimination ability of the endotracheal tube location using real-time palpation during intubation using an endotracheal tube with a preloaded stylet Palpation during intubation could be used as an ancillary method of providing real-time information of the endotracheal tube (ETT) placement before manual ventilation. This study aimed to evaluate the ability to discriminate the ETT location using a modified real-time palpation method with a preloaded stylet during intubation.The examiner (...) performing the real-time palpation method placed three fingers on the lateral sides of the trachea between the sternal notch and the thyroid cartilage to determine if endotracheal intubation was successful. Endotracheal intubation was confirmed by auscultation and quantitative carbon dioxide waveform using capnography.Eighty-eight patients were enrolled in this study. The discrimination accuracy of the real-time palpation method was 98.9% (95% CI: 93.8-99.8) for identifying the location of ETT between

2018 Therapeutics and clinical risk management

6. The Change of Endotracheal Tube Cuff Pressure During Laparoscopic Surgery. Full Text available with Trip Pro

The Change of Endotracheal Tube Cuff Pressure During Laparoscopic Surgery. We evaluated the endotracheal tube cuff pressure (Pcuff) changes during pneumoperitoneum for laparoscopic cholecystectomy and the correlations between body mass index (BMI), pneumoperitoneum time, and Pcuff changes.Total 60 patients undergoing laparoscopic cholecystectomy were allocated to either a study group (BMI ≥ 25 kg/m2) or a control group (BMI < 25 kg/m2). The endotracheal intubation was performed with a high (...) -volume low-pressure cuffed oral endotracheal tube. A manometer was connected to the pilot balloon using a 3-way stopcock and the cuff was inflated. The change in Pcuff was defined as the difference between the pressure just before intra-abdominal CO2 insufflation and the pressure before CO2 desufflation.Pcuff increased to 5.3 ± 3.6 cmH2O in the study group and 5.7 ± 5.4 cmH2O in the control group. There was no significant difference between two groups. While BMI was not correlated with change

2019 Open medicine (Warsaw, Poland) Controlled trial quality: uncertain

7. Microbiological analysis of endotracheal aspirate and endotracheal tube cultures in mechanically ventilated patients. Full Text available with Trip Pro

Microbiological analysis of endotracheal aspirate and endotracheal tube cultures in mechanically ventilated patients. To compare the microbiological culture within endotracheal aspirate specimens (ETAs) and endotracheal tube specimens (ETTs) in patients undergoing mechanical ventilation (MV) by statistical tools.ETAs and ETTs from a total number of 81 patients, who were undergoing MV at the intensive care unit (ICU) of Jiading Central Hospital Affiliated Shanghai University of Medicine & Health

2019 BMC pulmonary medicine

8. Benefits of using an endotracheal tube introducer as an adjunct to a Macintosh laryngoscope for endotracheal intubation performed by inexperienced doctors during mechanical CPR: A randomized prospective crossover study. Full Text available with Trip Pro

Benefits of using an endotracheal tube introducer as an adjunct to a Macintosh laryngoscope for endotracheal intubation performed by inexperienced doctors during mechanical CPR: A randomized prospective crossover study. 31171950 2019 06 18 1920-8642 10 3 2019 World journal of emergency medicine World J Emerg Med Benefits of using an endotracheal tube introducer as an adjunct to a Macintosh laryngoscope for endotracheal intubation performed by inexperienced doctors during mechanical CPR

2019 World journal of emergency medicine Controlled trial quality: uncertain

9. Effect of Endotracheal Tube Cuff Shape on Postoperative Sore Throat After Endotracheal Intubation (Abstract)

Effect of Endotracheal Tube Cuff Shape on Postoperative Sore Throat After Endotracheal Intubation Although minor, a sore throat after endotracheal intubation can adversely affect patient satisfaction and postoperative function. We compared the effects of 2 endotracheal tube cuff shapes on postoperative sore throat.One hundred ninety-one adult patients were included in the study. After induction of anesthesia, patients were randomized to endotracheal intubation with a conventional cylindrical (...) surgery than Group C (Bonferroni-corrected P< .05), but the incidence of hoarseness at 24 hours after surgery did not differ between groups.Intubation using an endotracheal tube with a tapered cuff reduced the incidence and severity of postoperative sore throat and the incidence of hoarseness after surgery when compared with an endotracheal tube with a cylindrical cuff.

2017 EvidenceUpdates

10. Randomised trial of estimating oral endotracheal tube insertion depth in newborns using suprasternal palpation of the tip or weight (Abstract)

Randomised trial of estimating oral endotracheal tube insertion depth in newborns using suprasternal palpation of the tip or weight Endotracheal tube (ETT) tip position is determined on chest X-ray (CXR) and should lie between the upper border of the first thoracic vertebra (T1) and the lower border of second thoracic vertebra (T2). Infant weight is commonly used to estimate how far the ETT should be inserted but frequently results in malpositioned ETT tips. Palpation of the ETT tip

2019 EvidenceUpdates

11. Benchmarking the Applicability of Four Methods of Endotracheal Tube Cuff Inflation for Optimal Sealing: A Randomized Trial. (Abstract)

Benchmarking the Applicability of Four Methods of Endotracheal Tube Cuff Inflation for Optimal Sealing: A Randomized Trial. To assess the comparable applicability of four methods of endotracheal tube cuff (ETTc) inflation on the basis of optimal level of intracuff pressure and presence of intubation-related complications.Double-blind, randomized trial.A total of 139 adult surgical patients scheduled to undergo nitrous oxide-free general anesthesia were assigned into one of four groups according

2018 Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses Controlled trial quality: uncertain

12. A randomized comparison of the prone ventilation endotracheal tube versus the traditional endotracheal tube in adult patients undergoing prone position surgery Full Text available with Trip Pro

A randomized comparison of the prone ventilation endotracheal tube versus the traditional endotracheal tube in adult patients undergoing prone position surgery Endotracheal tube displacement or dislocation is a severe complication that can occur in patients who require prone position ventilation. We hypothesized the prone position tube (PPT) would reduce the incidence of displacement of an endotracheal tube in an adult prone operation compared to a traditional tube (TT). A total of 80 adult (...) patients undergoing neurosurgery or spine surgery were recruited. Sixty patients with prone position ventilation were randomly divided into the traditional routine endotracheal tube group (Group TT, n = 30) and the prone position ventilation endotracheal tube group (Group PPT, n = 30). The primary outcome measures were the incidence of the endotracheal tube displacement during surgery, and the secondary outcomes were symptoms of sore throat, dysphagia and dysphonia during follow-up in the post

2017 Scientific reports

13. An approach for safe conversion of an oral endotracheal tube to a nasal endotracheal tube Full Text available with Trip Pro

An approach for safe conversion of an oral endotracheal tube to a nasal endotracheal tube We present an approach for safe management of a patient with an oral endotracheal tube who required conversion to a nasal endotracheal tube. A 35-year-old man presented for mandibular fracture repair after multiple injuries sustained in a motor vehicle accident. The patient already had an oral endotracheal tube, and the surgical team requested a nasal endotracheal tube to facilitate surgical exposure (...) and postoperative airway management in anticipation of a wired jaw. A nasal endotracheal tube was inserted through the naris and a video laryngoscope was used to visualize the glottis. A tracheal tube introducer was inserted through the oral endotracheal tube, and the oral endotracheal tube was then withdrawn approximately 5 cm. The nasal endotracheal tube was advanced through the vocal cords alongside the tracheal tube introducer. The nasal endotracheal tube cuff was then inflated and the tracheal tube

2017 Proceedings (Baylor University. Medical Center)

14. Incidence of endotracheal tube colonization with the use of PneuX endotracheal tubes in patients following cardiac surgery. Full Text available with Trip Pro

Incidence of endotracheal tube colonization with the use of PneuX endotracheal tubes in patients following cardiac surgery. Ventilator-associated pneumonia (VAP) develops in up to 25% of patients following cardiac surgery. Colonization of the endotracheal tube (ETT) contributes to VAP. The PneuX ETT has been shown to halve VAP in high-risk patients undergoing cardiac surgery. This article reports on the secondary analysis of bacterial colonization in relation to VAP between the PneuX

2017 The Journal of hospital infection Controlled trial quality: uncertain

15. Epistaxis during nasotracheal intubation: a randomized trial of the Parker Flex-Tip™ nasal endotracheal tube with a posterior facing bevel versus a standard nasal RAE endotracheal tube. Full Text available with Trip Pro

Epistaxis during nasotracheal intubation: a randomized trial of the Parker Flex-Tip™ nasal endotracheal tube with a posterior facing bevel versus a standard nasal RAE endotracheal tube. Nasotracheal intubation is a widely performed technique to facilitate anesthesia induction during oral, dental, and maxillofacial surgeries. The technique poses several risks not encountered with oropharyngeal intubation, most commonly epistaxis due to nasal mucosal abrasion. The purpose of this study (...) was to test whether the use of the Parker Flex-Tip™ (PFT) nasal endotracheal tube (ETT) with a posterior facing bevel reduces epistaxis when compared with the standard nasal RAE ETT with a leftward facing bevel.Sixty American Society of Anesthesiologists physical status I and II patients undergoing oral or maxillofacial surgery with nasotracheal intubation were recruited. Patients were randomized to either a standard nasal RAE ETT or a PFT nasal ETT. The ETT was thermosoftened and lubricated for both

2017 Canadian Journal Of Anaesthesia Controlled trial quality: predicted high

16. Cuffed endotracheal tubes in children: the effect of the size of the cuffed endotracheal tube on intracuff pressure. (Abstract)

Cuffed endotracheal tubes in children: the effect of the size of the cuffed endotracheal tube on intracuff pressure. In children, the size of the cuffed endotracheal tube is based on various age-based formulas. However, such formulas may over or underestimate the size of the cuffed endotracheal tube. There are no data on the impact of different-sized cuffed endotracheal tubes (ETT) on the intracuff pressure in children.The current study measures intracuff pressure with different-sized cuffed (...) divided into two groups to receive either a cuffed endotracheal tube based on the Khine formula (Group R) or a cuffed endotracheal tube that was a half-size (0.5 mm ID) smaller (Group S). Following the inflation of the cuff to seal the trachea, the intracuff pressure was measured.In the in vitro phase, the intracuff pressure was 45 ± 6, 23 ± 1, and 14 ± 6 cmH2 O with size 4.0, 4.5, and 5 mm ID cuffed ETT, respectively (F-test P < 0.001 for difference among three groups). In the in vivo phase, the mean

2017 Paediatric anaesthesia Controlled trial quality: uncertain

17. Comparison of the cuff pressure of a TaperGuard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during middle ear surgery: A single-blind, randomized clinical consort study. Full Text available with Trip Pro

Comparison of the cuff pressure of a TaperGuard endotracheal tube and a cylindrical endotracheal tube after lateral rotation of head during middle ear surgery: A single-blind, randomized clinical consort study. Positional change affects the cuff pressure of an endotracheal tube (ETT) in treacheally intubated patients. We compared the cuff pressure of a TaperGuard ETT and a cylindrical ETT after lateral rotation of head during middle ear surgery.Fifty-two patients aged 18-70 years underwent (...) a tympanomastoidectomy under general anesthesia were randomly allocated to receive endotracheal intubation with cylindrical (group C, n = 26) or TaperGuard ETTs (group T, n = 26). After endotracheal intubation, the ETT cuff pressure was set at 22 cmH2O in the neutral position of head. After lateral rotation of head, the cuff pressure was measured again and readjusted to 22 cmH2O. In addition, the change of distance from the carina to the tip of the ETT was measured before and after the positional change

2017 Medicine Controlled trial quality: uncertain

18. Can Transtracheal Ultrasonography Be Used to Verify Endotracheal Tube Placement?

Can Transtracheal Ultrasonography Be Used to Verify Endotracheal Tube Placement? Systematic Review Snapshot TAKE-HOME MESSAGE During emergency intubations, transtracheal ultrasonography can be used to assess endotracheal tube placement before con?rmation with capnography. Can Transtracheal Ultrasonography Be Used to Verify Endotracheal Tube Placement? EBEM Commentators Michael Gottlieb, MD John Bailitz, MD Department of Emergency Medicine Cook County Hospital Chicago, IL Results Twelve studies (...) ). The Cochran Q and inconsistency index indicated minimal to moderate variation across thestudies. Commentary Con?rmation of proper placement of an endotracheal tube is essential because unrecognized esophageal Table. Sensitivity and speci?city of transtracheal ultrasonography for determining intubation. Outcome Measure Sensitivity (95% CI) Speci?city (95% CI) Number of Studies (Number of Patients) Pooled data 0.98 (0.97–0.99) 0.98 (0.95–0.99) 11 (969) Emergency intubations 0.98 (0.97–0.99) 0.94 (0.86–0.98

2015 Annals of Emergency Medicine Systematic Review Snapshots

19. Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. Full Text available with Trip Pro

Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. Emergency medical services (EMS) commonly perform endotracheal intubation (ETI) or insertion of supraglottic airways, such as the laryngeal tube (LT), on patients with out-of-hospital cardiac arrest (OHCA). The optimal method for OHCA advanced airway management is unknown.To compare the effectiveness of a strategy

2018 JAMA Controlled trial quality: predicted high

20. Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation: A Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation: A Randomized Clinical Trial. The tracheal tube introducer, known as the bougie, is typically used to aid tracheal intubation in poor laryngoscopic views or after intubation attempts fail. The effect of routine bougie use on first-attempt intubation success is unclear.To compare first attempt intubation success facilitated (...) by the bougie vs the endotracheal tube + stylet.The Bougie Use in Emergency Airway Management (BEAM) trial was a randomized clinical trial conducted from September 2016 through August 2017 in the emergency department at Hennepin County Medical Center, an urban, academic department in Minneapolis, Minnesota, where emergency physicians perform all endotracheal intubations. Included patients were 18 years and older who were consecutively admitted to the emergency department and underwent emergency orotracheal

2018 JAMA Controlled trial quality: predicted high

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