Objective: The effect of using uncuffed endotracheal tubes in children during interfacility critical care transport has not yet been assessed. We hypothesized that many children with uncuffed endotracheal tubes experience complications leading to replacement with a cuffed tube after arrival at a tertiary pediatric care facility.
Methods: We conducted a retrospective case review of all intubated patients transported by our dedicated pediatric critical care transport team to our pediatric intensive care unit over a 3-year period. The incidence of urgent reintubation was studied.
Results: A total of 213 children were referred for transport with an endotracheal tube in place, with 55 of those with an uncuffed endotracheal tube (25.8% of all intubated patients). Of those with uncuffed tubes, 24 patients needed their tubes replaced on an urgent basis by the medical team because of issues with ineffective ventilation (43.6% of patients with uncuffed tubes or 11.3% of all intubated patients). No cuffed tubes required replacement.
Conclusion: Placing an uncuffed endotracheal tube in the critically ill child who is referred to tertiary pediatric care results in a significant number of these patients undergoing a repeat laryngoscopy, with all associated risks, to replace the uncuffed tube with a cuffed tube.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.amj.2018.10.002 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Endoscopic Screening for Laryngotracheal Complications in Children Following Prolonged Mechanical Ventilation Maintained Through Endotracheal Intubation: A Cross-Sectional Pilot Project.
Ann Otol Rhinol Laryngol
December 2024
Department of Otorhinolaryngology & Head-Neck Surgery, Medical College & Hospital, Kolkata; West Bengal, India.
Background: An endoscopic screening program following successful weaning from prolonged mechanical ventilation maintained through endotracheal tube (ET; ) may be justified to assess the upper (laryngotracheal) airway in children who may not always be symptomatic for intubation-related complications.
Objectives: To evaluate effects of prolonged intubation in children through endoscopic screening of the laryngotracheal airway.
Methods: In this cross-sectional pilot project, children (2 months-12 years) successfully extubated following prolonged intubation were selected, irrespective of having symptoms, for a 1-time flexible nasolaryngoscopy at third to sixth month post-extubation (follow-up window).
Exchange rates of second generation Microcuff® pediatric endotracheal tubes in children weighing more than 3 kg : A retrospective audit.
Anaesthesiologie
December 2024
Department of Anesthesia, University Children's Hospital, Lenggstrasse 30, 8008, Zurich, Switzerland.
Background: Cuffed endotracheal tubes (cETT) pose the potential advantage of an infrequent need for reintubation in pediatric patients compared to uncuffed tubes. The aim of this study was to investigate tube exchange rates using second generation Microcuff® pediatric endotracheal tubes (PET) with an adapted sizing recommendation in a large single institution cohort of children and to identify potential variables associated with an elevated risk of tube exchange.
Methods: Patient data obtained from the electronic patient data management system of the Department of Anesthesia, University Children's Hospital Zurich, Switzerland, were retrospectively assessed for demographic and anthropometric information, size of the internal tube diameter used for positive pressure ventilation and divergence from the size recommendation chart.
Neonatal Airway Management and Outcomes Following Fetoscopic Endoluminal Tracheal Occlusion (FETO): A Single-Center Descriptive Analysis.
J Surg Res
December 2024
Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital and Baylor, College of Medicine, Houston, Texas; Texas Children's Fetal Center, Baylor College of Medicine, Houston, Texas. Electronic address:
Article Synopsis
- Congenital diaphragmatic hernia is a serious condition that can lead to issues like underdeveloped lungs and high blood pressure, but a procedure called fetoscopic endoluminal tracheal occlusion (FETO) has shown to improve patient survival despite some complications like tracheomegaly (enlarged trachea).
- A study analyzed 34 patients who underwent FETO, finding that tracheomegaly was present in 24 of them, with most needing intubation right after birth, some requiring a transition to cuffed endotracheal tubes (ETTs) due to concerns like air leaks.
- The findings suggest that larger or cuffed ETTs may be more beneficial for
Design considerations for development of cuffed endotracheal tube for small airways.
Paediatr Anaesth
November 2024
Research and Development, Acute Care & Monitoring, Medtronic, Athlone, Ireland.
Article Synopsis
- * Neonates and pediatric patients have specific airway structures and functional needs that influence the design of ETTs, making it important to cater to these requirements.
- * While historically uncuffed ETTs were preferred for children under eight, advancements in cuffed ETT design now allow for safer use in smaller, more delicate airways.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!