Cuffed vs non‐cuffed endotracheal tubes for pediatric anesthesia

Cuffed endotracheal tubes in paediatrics

“…16 Oversized outer tube diameters, inadequately designed cuffs, wrongly positioned or missing depth marks and cuff overinflation have been identified as causes of airway damage in children managed with a cuffed tube. The choice of an optimally sized CETT requires that the inner diameter, as well as the outer diameter, is taken into account.…”

“…15 Despite these potential problems, UETTs remains popular and with experience, paediatric anaesthetists have learnt to overcome these shortcomings effectively. 16 An oversized UETT exerts undue pressure on the laryngeal structures and causes laryngeal injury. Even if an UETT reasonably seals the trachea and has a leak, the pressure that is exerted on some parts of the cricoid mucosa may still be excessive.…”

Tubos endotraqueales con cuff en anestesia pediátrica: ¿aumentan el riesgo de estridor post-extubación? Estudio observacional, cohorte prospectiva

“…Por esta razón, no se recomendaba el uso de tubos con cuff en anestesia pediátrica para así evitar la lesión de la mucosa laríngea, manifestada por un espectro de complicaciones, desde estridor hasta secuelas más complejas 4,5,6 . El uso de cuff ofrece múltiples ventajas 7 como un mejor sello y protección de la vía aérea, menor necesidad de cambios de tubos, disminución de la contaminación ambiental por gases anestési-cos, medición más exacta del CO 2 espirado y de los parámetros ventilatorios.…”

“…The cuffed tracheal tubes effect on stridor risk, (adjusting for confounders), was non-significant: OR = 2,2; Conf. Interval 95% [0, [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]; p = 0,5. Conclusions: The use of cuffed endotracheal tubes did not increase the risk of post-extubation stridor in children.…”

The effect of pilot balloon design on estimation of safe tracheal tube cuff pressure

“…A subsequent Intensive Care Society guideline [11] recommends that tracheostomy cuff pressure should be checked regularly with a manometer and kept below 25 cmH 2 O. It is not standard practice to check tracheal tube cuff pressures routinely during anaesthesia [12] despite several studies concluding that this is best practice [13][14][15]. Evaluation of cuff pressures using clinical endpoints, such as palpation or air leak, has been shown to be inaccurate in patients in theatre [14,15], intensive care [10,16,17], and the emergency department [18].…”