Evaluation of a new recommendation for improved cuffed tracheal tube size selection in infants and small children

Abstract

The new recommendation presented for the use of second-generation Microcuff PETs with improved OD to ID ratio allows the selection of cuffed tracheal tubes with larger IDs than previously recommended for small children without increased need for tracheal tube exchange or increased incidence of post-intubation stridor in these age groups.

Use of cuffed tracheal tubes in neonates, infants and children: A practice survey of members of the Society of Pediatric Anesthesia

“…There is no appropriate sized CTT available for use in preterm and term neonates who weigh b 3 kg. The smallest Microcuff CTT, 3.0 mm ID, is recommended for term neonates N 3 kg [10]. Recently we reported a concerning incidence of post-extubation stridor in preterm infants whose airways were managed with these Microcuff® TT, an incidence that was 2-fold greater than that for UTT [11,12].…”

Cuffed endotracheal tubes in paediatrics

“…Second-generation microcuff tracheal tubes with an ID of 3.5 mm should be used in infants from eight or nine months onwards to reduce the tracheal tube exchange rates. 6 They should be the first choice when a tube with an ID of 3.5 mm or more is selected. 20 A leak should be present at 20 cmH 2 O before inflating the cuff, which must be placed below the cricoid area.…”

“…In contrast, larger diameter UETTs that are selected to seal the airway within the noncircular cricoid cause pressure damage on the internal mucosal layer. 6 without prior anatomical knowledge can have serious consequences. The airways of children differ from those of adults and undergo significant changes from birth to schoolgoing age.…”

Pharyngolaryngeale Beschwerden nach Allgemeinanästhesien

“…Eine kürzlich veröffentliche Studie mit neuen 7 Microcuffendotrachealtuben der 2. Generationen zeigte viel versprechende Resultate hinsichtlich Verbesserung der Tubuswahl und dem Auftreten von Atemwegsirritationen [44].…”