Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 3 , ISSUE 2 ( July-December, 2014 ) > List of Articles

Original Article

A comparative study of paediatric endotracheal tubes available in the Indian market – a bench study

Harshan Arul, Jasvinder Kaur

Keywords : Cuff, margin of safety, paediatric endotracheal tubes

Citation Information : Arul H, Kaur J. A comparative study of paediatric endotracheal tubes available in the Indian market – a bench study. Indian J Respir Care 2014; 3 (2):431-439.

DOI: 10.5005/ijrc-3-2-431

License: NA

Published Online: 30-11-2022

Copyright Statement:  NA


Introduction: A variety of paediatric endotracheal tubes (ETT) are available in India. Aim: Comparison of paediatric cuffed and uncuffed ETT with respect to dimensions, depth markings, cuff characteristics and cost. Methods: 65 cuffed and 38 uncuffed paediatric ETT (3.0-7.0 mm ID) from 12 different manufacturers were evaluated. The outer diameter, position of depth markings, length and position of cuff, largest diameter of cuff inflated at 20 cm H2O of the ETTs were measured and compared with dimensions of trachea. Results: Outer diameters of similar ID ETTs varied between manufacturers and between cuffed and uncuffed ETTs from the same manufacturer. 26 tubes studied did not have a depth marking. In many tubes the distances from depth marking to tube tip were greater than half the age-related minimum tracheal length. If the tube tips were placed in midtrachea, many cuffs were placed within the larynx. If cuffs were placed 0.5 cm below cricoid level, many tube tips lay too close to the carina. Diameters and cross-sectional area of the cuff at 20 cm H2O pressure mostly covered maximal internal age related tracheal diameters and cross sectional areas. Conclusion: Most paediatric ETTs are poorly designed. ETTs from Kimberly Clark and Parker tubes for children suit paediatric tracheal dimensions. All cuffed tubes including Kimberly Clark tubes need close cuff pressure monitoring.

  1. Ho AMH, Aun CST, Karmakar MK. The margin of safety associated with the use of cuffed paediatric tracheal tubes. Anaesthesia 2002; 57: 169-72.
  2. Weiss M1, Knirsch W, Kretschmar O, et al. Tracheal tube tip displacement in children during head – neck movement- radiological assessment. Br J Anaesth 2006; 96:486-91.
  3. Griscom NT, Wohl MEB. Dimensions of the growing trachea related to age and gender. Am J Roentgenol 1986; 146: 233-7.
  4. Latto P. The cuff. In: Latto IP, Vaughan RS, eds. Difficulties in tracheal Intubation. London: WB Saunders Co., 1997; 51-78.
  5. Murat I. Cuffed tubes in children: a 3-year experience in a single institution. Paediatr Anaesth 2001;11:748-9.
  6. Jones R, Ueda I. Cuff bulk of tracheal tubes in adolescence. Can J Anaesth 1996; 43:514-7.
  7. Morgan GAR, Steward DJ. Linear airway dimensions in children. Including those with cleft palate. Can Anaesth Soc J 1982; 29:1-8.
  8. Seegobin RD, van Hasselt GL. Tracheal cuff pressure and tracheal mucosal bloodflow: endoscopic study of effects of four large volume cuffs. BMJ 1984; 288:965-68.
  9. Weiss M, Dullenkopf A, Gysin C, Dillier CM, Gerber AC. Shortcomings of cuffed paediatric tracheal tubes. Br J Anaesth 2004;92:78-88.
  10. Freemann JA, Fredricks BJ, Best CJ. Evaluation of a new method for determining tracheal tube length in children. Anaesthesia 1995; 50:1050-2.
  11. Goulds SJ, Howard S. The histopathology of the larynx in the neonate following tracheal intubation. J Pathol 1985; 146:301-11.
  12. Cavo JW. True vocal cord paralysis following intubation. Laryngoscope 1985; 95:1352-9.
  13. Okuyama M, Imai M, Sugawara K, et al. Finding appropriate tube position by the cuff palpation method in children. Masui 1995; 44:845-8
  14. Fearon B, Whalen JS. Tracheal dimensions in the living infant. Ann Oto Rhino Laryngol 1967; 76:964-74.
  15. McGinnis, G.E., Shiley, J.G., Patterson, R.L. and Magovern, G.J. An engineering analysis of intratracheal tube cuffs. Anesth Analg 1971; 50: 557-64.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.