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cuffed vs uncuffed tube in children

Michel de Wit, Linda M Peelen, Leo van Wolfswinkel, Jurgen C de Graaff
BACKGROUND: The use of cuffed vs uncuffed endotracheal tubes in pediatric anesthesia is widely debated. This study aimed to investigate whether the use of cuffed vs uncuffed tubes is associated with an increased incidence of acute postoperative respiratory complications. METHODS: We retrospectively studied all children aged 0-7 years in which the trachea was intubated between September 28, 2006 and August 26, 2016 in a pediatric university hospital. Logistic regression analysis was performed to estimate the association between tube design (cuffed vs uncuffed) and the incidence of acute postoperative respiratory complications (stridor, wheezing, or dyspnea; desaturations ≤90%) in need of intervention (epinephrine, dexamethasone, nebulizers, supplementary oxygen, or reintubation), adjusting for potential confounders...
March 2018: Paediatric Anaesthesia
Rebecca E Thomas, Shripada C Rao, Corrado Minutillo, Bruce Hullett, Max K Bulsara
BACKGROUND: Cuffed endotracheal tubes are being increasingly used in infants; however, current evidence in the literature mostly includes infants ≥ 3-kg weight. AIMS: The aim of this observational study was to compare the short-term outcomes with the use of Microcuff® cuffed vs uncuffed endotracheal tubes in neonates < 3 kg. METHODS: We performed a retrospective cohort study in a single-centre, tertiary children's hospital neonatal intensive care unit...
March 2018: Paediatric Anaesthesia
N A Chambers, A Ramgolam, D Sommerfield, G Zhang, T Ledowski, M Thurm, M Lethbridge, M Hegarty, B S von Ungern-Sternberg
Cuffed tracheal tubes are increasingly used in paediatric anaesthetic practice. This study compared tidal volume and leakage around cuffed and uncuffed tracheal tubes in children who required standardised mechanical ventilation of their lungs in the operating theatre. Children (0-16 years) undergoing elective surgery requiring tracheal intubation were randomly assigned to receive either a cuffed or an uncuffed tracheal tube. Assessments were made at five different time-points: during volume-controlled ventilation 6 ml...
February 2018: Anaesthesia
J Herzog-Niescery, P Gude, F Gahlen, H-M Seipp, H Bartz, N M Botteck, M Bellgardt, S Dazert, T P Weber, H Vogelsang
Although sevoflurane is commonly used in anaesthesia, a threshold value for maximum exposure to personnel does not exist and although anaesthetists are aware of the problem, surgeons rarely focus on it. We used a photo-acoustic infrared device to measure the exposure of surgeons to sevoflurane during paediatric adenoidectomies. Sixty children were randomly allocated to laryngeal mask, cuffed tracheal tube or uncuffed tracheal tube. The average mean (maximum) sevoflurane concentrations within the surgeons' operating area were 1...
August 2016: Anaesthesia
Robinder G Khemani, Justin Hotz, Rica Morzov, Rutger Flink, Asavari Kamerkar, Patrick A Ross, Christopher J L Newth
RATIONALE: Subglottic edema is the most common cause of pediatric extubation failure, but few studies have confirmed risk factors or prevention strategies. This may be due to subjective assessment of stridor or inability to differentiate supraglottic from subglottic disease. OBJECTIVES: Objective 1 was to assess the utility of calibrated respiratory inductance plethysmography (RIP) and esophageal manometry to identify clinically significant post-extubation upper airway obstruction (UAO) and differentiate subglottic from supraglottic UAO...
January 15, 2016: American Journal of Respiratory and Critical Care Medicine
S Eschertzhuber, B Salgo, A Schmitz, W Roth, A Frotzler, C H Keller, A C Gerber, M Weiss
BACKGROUND: This study aims to evaluate sevoflurane and anaesthetic gas consumption using uncuffed vs. cuffed endotracheal tubes (ETT) in paediatric surgical patients. METHODS: Uncuffed or cuffed ETT were used in paediatric patients (newborn to 5 years) undergoing elective surgery in a randomized order. Duration of assessment, lowest possible fresh gas flow (minimal allowed FGF: 0.5 l/min) and sevoflurane concentrations used were recorded. Consumption and costs for sevoflurane and medical gases were calculated...
August 2010: Acta Anaesthesiologica Scandinavica
M Weiss, A Dullenkopf, J E Fischer, C Keller, A C Gerber
BACKGROUND: The use of cuffed tracheal tubes (TTs) in small children is still controversial. The aim of this study was to compare post-extubation morbidity and TT exchange rates when using cuffed vs uncuffed tubes in small children. METHODS: Patients aged from birth to 5 yr requiring general anaesthesia with TT intubation were included in 24 European paediatric anaesthesia centres. Patients were prospectively randomized into a cuffed TT group (Microcuff PET) and an uncuffed TT group (Mallinckrodt, Portex, Rüsch, Sheridan)...
December 2009: British Journal of Anaesthesia
P E Flynn, A E Black, V Mitchell
BACKGROUND AND OBJECTIVE: For more than 50 yr, uncuffed tracheal tubes have been the gold standard for intubation in children under the age of 8 yr. However, recently there has been interest in the use of cuffed tubes in paediatric practice. This survey aimed to benchmark UK practice with regard to tracheal intubation within specialist paediatric centres, exploring current cuffed tracheal tube use in children. METHODS: A questionnaire was e-mailed to the paediatric intensive care unit and anaesthetic department clinical leads in all UK specialist paediatric hospitals with a paediatric intensive care unit (n = 30)...
August 2008: European Journal of Anaesthesiology
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