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Endotracheal Tube

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1. WITHDRAWN: Techniques to ascertain correct endotracheal tube placement in neonates. (PubMed)

WITHDRAWN: Techniques to ascertain correct endotracheal tube placement in neonates.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

2. Laryngeal mask airway versus endotracheal tube for percutaneous dilatational tracheostomy in critically ill adults. (PubMed)

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

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. Cuffed versus uncuffed endotracheal tubes for general anaesthesia in children aged eight years and under. (PubMed)

Cuffed versus uncuffed endotracheal tubes for general anaesthesia in children aged eight years and under. Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving (...) on the use of cuffed versus uncuffed endotracheal tubes in children of eight years old or less.To assess the risks and benefits of cuffed versus uncuffed endotracheal tubes during general anaesthesia in children up to eight years old.We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS and Google Scholar databases from their inception until March 2017. We also searched databases of ongoing trials, and checked references and citations. We imposed no restriction by language.We included randomized and quasi

2017 Cochrane

5. Discrimination ability of the endotracheal tube location using real-time palpation during intubation using an endotracheal tube with a preloaded stylet (PubMed)

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

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2018 Therapeutics and clinical risk management

6. Effect of Endotracheal Tube Cuff Shape on Postoperative Sore Throat After Endotracheal Intubation

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

7. Microbiological analysis of endotracheal aspirate and endotracheal tube cultures in mechanically ventilated patients. (PubMed)

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. Endotracheal tubes for subglottic suctioning

Endotracheal tubes for subglottic suctioning Endotracheal tubes for subglottic suctioning Endotracheal tubes for subglottic suctioning Mitchell, MD, Jablonski, J, Umscheid, CA Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Mitchell, MD, Jablonski, J, Umscheid, CA. Endotracheal tubes for subglottic suctioning. Philadelphia: Center

2016 Health Technology Assessment (HTA) Database.

9. Randomised trial of estimating oral endotracheal tube insertion depth in newborns using suprasternal palpation of the tip or weight

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

10. Incidence of endotracheal tube colonization with the use of PneuX endotracheal tubes in patients following cardiac surgery. (PubMed)

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

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2017 The Journal of hospital infection

11. 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. (PubMed)

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

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2017 Canadian Journal Of Anaesthesia

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

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

13. 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. (PubMed)

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

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2017 Medicine

14. A randomized comparison of the prone ventilation endotracheal tube versus the traditional endotracheal tube in adult patients undergoing prone position surgery (PubMed)

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

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2017 Scientific reports

15. An approach for safe conversion of an oral endotracheal tube to a nasal endotracheal tube (PubMed)

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

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2017 Proceedings (Baylor University. Medical Center)

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

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

17. A comparison of the impact of cuffed versus uncuffed endotracheal tubes on the incidence of tracheal tube exchange and on post-extubation airway morbidity in pediatric patients undergoing general anesthesia: a systematic review protocol. (PubMed)

A comparison of the impact of cuffed versus uncuffed endotracheal tubes on the incidence of tracheal tube exchange and on post-extubation airway morbidity in pediatric patients undergoing general anesthesia: a systematic review protocol. The objective of this systematic review is to synthesize the best available evidence regarding the impact of cuffed versus uncuffed endotracheal tubes on the incidence of tracheal tube exchange during the perioperative period and on post-extubation airway

2016 JBI database of systematic reviews and implementation reports

18. A Comparison of the Haider Tube-Guard® Endotracheal Tube Holder Versus Adhesive Tape to Determine if This Novel Device Can Reduce Endotracheal Tube Movement and Prevent Unplanned Extubation. (PubMed)

A Comparison of the Haider Tube-Guard® Endotracheal Tube Holder Versus Adhesive Tape to Determine if This Novel Device Can Reduce Endotracheal Tube Movement and Prevent Unplanned Extubation. Endotracheal tube security is a critical safety issue. We compared the mobility of an in situ endotracheal tube secured with adhesive tape to the one secured with a new commercially available purpose-designed endotracheal tube-holder device (Haider Tube-Guard). We also observed for the incidence (...) of oropharyngeal or facial trauma associated with the 2 tube fixation methods.Thirty adult patients undergoing general anesthesia with neuromuscular blockade were prospectively enrolled. Immediately after intubation, a single study author positioned the endotracheal tube tip in the distal trachea using a bronchoscope. Anesthesiologists caring for patients secured the tube in their normal fashion (always with adhesive tape). A force transducer was used to apply linear force, increasing to 15 N or until

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2016 Anesthesia and Analgesia

19. Silver-coated endotracheal tubes for prevention of ventilator-associated pneumonia in critically ill patients. (PubMed)

Silver-coated endotracheal tubes for prevention of ventilator-associated pneumonia in critically ill patients. Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in intubated and mechanically ventilated patients. Endotracheal tubes (ETTs) appear to be an independent risk factor for VAP. Silver-coated ETTs slowly release silver cations. It is these silver ions that appear to have a strong antimicrobial effect. Because of this antimicrobial effect of silver

2015 Cochrane

20. Prevention of Ventilator-Associated and Early Postoperative Pneumonia Through Tapered Endotracheal Tube Cuffs: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Prevention of Ventilator-Associated and Early Postoperative Pneumonia Through Tapered Endotracheal Tube Cuffs: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Microaspiration of subglottic secretions is considered a major pathogenic mechanism of hospital-acquired pneumonia, either early postoperative or ventilator-associated pneumonia. Tapered endotracheal tube cuffs have been proposed to provide a better seal of the extraluminal airway, thereby preventing microaspiration (...) and possibly hospital-acquired pneumonia. We performed a systematic review and meta-analysis to assess the value of endotracheal tubes with tapered cuffs in the prevention of hospital-acquired pneumonia.A systematic search of MEDLINE, EMBASE, CENTRAL/CCTR, ClinicalTrials.gov, and ICTRP was conducted up to March 2017.Eligible trials were randomized controlled clinical trials comparing the impact of tapered cuffs versus standard cuffs on hospital-acquired pneumonia.Random-effects meta-analysis calculated

2018 EvidenceUpdates

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