Cuffed versus uncuffed endotracheal tubes for neonates

Dariya, Vedanta; Moresco, Luca; Bruschettini, Matteo; Brion, Luc P.

doi:10.1002/14651858.cd013736

Cited by 3 publications

(10 citation statements)

References 69 publications

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“…3 Although this can be construed as a protective advantage, there is also a concern that this will, in turn, lead to increased airway resistance and episodes of ETT obstruction. 3 4 5 This increase in airway resistance, although measurable, is unlikely to hold any clinical significance for tubes with ID ≥ 3.0 mm. 3 10 11…”

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

“…1 2 4 5 6 Cuffed ETTs are also thought to be associated with lower rates of microaspiration in ventilated children, which could reduce the risk of ventilator-associated pneumonia. 1 4 5 On the contrary, gas leaks around an uncuffed ETT may require more frequent tube replacement, increase anesthetic gas contamination in the operating room, make end-tidal gas monitoring less reliable, and cause inadequate ventilation. 7…”

Section: Introductionmentioning

confidence: 99%

“…3 5 Airway injury is usually not associated with the presence of a cuffed ETT but mostly secondary to other factors including multiple intubation attempts, prolonged duration of mechanical ventilation, concurrent upper respiratory infection, frequent aspiration, and inappropriate ETT size. 4 5…”

Section: Introductionmentioning

confidence: 99%

“…2 The advent of the newer polyvinyl chloride high-volume, low-pressure cuffed ETTs in the 1990s, followed by the introduction of the ultrathin polyurethane pediatric ETT Microcuff in 2004, led to an increase in the use of cuffed ETTs in the pediatric population and to considering its use with small infants and neonates. 1,3,4 The aim of using cuffed ETTs is backed up by its multiple potential benefits: improved oxygenation; small or absent gas leaks around the ETTs, leading to fewer manipulations to upsize the ETTs; more accurate capnographic tracing; maintenance of airway pressures; and reduction of accidental extubation, therefore decreasing the reintubation rates. 1,2,[4][5][6] Cuffed ETTs are also thought to be associated with lower rates of microaspiration in ventilated children, which could reduce the risk of ventilator-associated pneumonia.…”

Section: Introductionmentioning

confidence: 99%

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Cuffed Endotracheal Tubes in Neonates

Gaspar

Rocha

Gonçalves

2023

J Pediatr Intensive Care

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Cuffed endotracheal tubes (ETTs) are becoming increasingly used in neonates; nevertheless, current data in the literature mostly include infants over 3,000 g in weight. The aim of this study was to compare the use of cuffed and uncuffed ETTs in neonates in the neonatal intensive care unit of a tertiary children's hospital, assessing the presence of airway complications. We performed a single-center retrospective cohort study. Our study included all term neonates receiving cuffed ETTs over the period from January 2019 to December 2021. The controls were all neonates receiving an uncuffed ETT over the same period. Twenty-five patients were intubated with cuffed ETTs in the study period. The group receiving cuffed ETTs was compared with 53 patients receiving uncuffed ETTs. All cuffed ETTs were inserted in the operating room by anesthesiologists. Comparing the outcomes of the cuffed ETT group with controls, there were no significant differences in the number of unplanned extubations, reintubation episodes, ventilator-associated pneumonia, episodes of atelectasis, the use of dexamethasone, or vocal cord paresis. No unplanned extubation was observed in the cuffed ETT group, and no cases of subglottic stenosis were observed in either of the groups. This retrospective study with a small sample size suggests that the use of cuffed ETTs in surgical patients >2,000 g in weight is not associated with an increase in airway complications. Well-designed randomized controlled trials are needed to compare cuffed ETTs with uncuffed ETTs.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cuffed Endotracheal Tubes in Neonates

Gaspar

Rocha

Gonçalves

2023

J Pediatr Intensive Care

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Cuffed versus uncuffed endotracheal tubes for neonates

Dariya

Moresco

Bruschettini

et al. 2022

Cochrane Database of Systematic Reviews

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Mechanical ventilation core outcome set uptake in Cochrane systematic reviews: A cross‐sectional study

Garegnani,

Ivaldi,

Burgos

et al. 2024

Cochrane Evidence Synthesis and Methods

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IntroductionThe Cochrane Handbook acknowledges core outcome sets' (COS) relevance in defining review questions and planning systematic reviews. We aimed to assess the uptake of the mechanical ventilation (MV) COS in Cochrane systematic reviews of interventions.MethodsA cross‐sectional study. We included Cochrane systematic reviews and protocols of Cochrane systematic reviews of any intervention related to mechanically ventilated patients through a search in the Cochrane database of systematic reviews. We did not apply restrictions based on age or setting. One reviewer assessed the studies for eligibility and extracted data. Both processes were validated by a second author.ResultsWe identified 233 reviews and protocols through our search strategy. We finally included 36 records. Thirty‐four (94.44%) were Cochrane reviews and two (5.56%) were protocols. The included Cochrane reviews and protocols assessed a median of 13 (interquartile range [IQR]: 9–17) outcomes, with 35 (97.22%) reviews reporting at least one outcome from the MV COS. The median number of outcomes from the MV COS reported in the Cochrane reviews and protocols was 2.5 (IQR: 2–3). Only one (2.78%) study reported all the outcomes from the MV COS. None of the included Cochrane reviews and protocols cited the MV COS publication.ConclusionCompleted Cochrane systematic reviews and protocols of Cochrane systematic reviews of interventions related to mechanically ventilated patients have an overall limited uptake of the MV COS so far. Mortality and duration of stay were the most reported outcomes, while extubation and reintubation were the least informed. These findings may serve as a starting point for the Cochrane Critical Care community to develop dissemination strategies for improving the MV COS uptake.

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Cuffed versus uncuffed endotracheal tubes for neonates

Cited by 3 publications

References 69 publications

Cuffed Endotracheal Tubes in Neonates

Cuffed Endotracheal Tubes in Neonates

Cuffed versus uncuffed endotracheal tubes for neonates

Mechanical ventilation core outcome set uptake in Cochrane systematic reviews: A cross‐sectional study

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