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.
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.
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