Small Endotracheal Tubes. Ventilator and Intratracheal Pressures during Controlled Ventilation

Tracheal Size Variability Is Associated With Sex

“…Anecdotal evidence and discussions with colleagues (A. Blanchard, pulmonary, personal communication, November 1, 2013; S. Dubin, anesthesiology, personal communication, August 2, 2014; G. Sandhu, otolaryngology, personal communication, December 7, 2010) suggest that adult airway decision-making paradigms are largely clinician dependent. 21 It is interesting that a recent study even suggested decreased air leaks around ETT cuffs in small versus larger ETTs owing to the presence of redundant folds in the cuff of larger ETTs. One recommendation by a commercial ETT manufacturer suggested ETT sizing at "7.5 or 8.0 mm for females and 8.5, 9.0 or 9.5 mm for males."…”

Size matters: choosing the right tracheal tube

“…There can be little argument with Stenqvist et al’s demonstration of minimal changes in ventilator pressures during routine anaesthesia using tubes as small as 6.0 mm [8]. Spontaneous breathing through a tracheal tube during anaesthesia is a largely redundant technique with the advent of the LMA and most healthy patients can cope with a few minutes’ breathing through a small tube at the end of anaesthesia.…”

Small tubes revisited

“…Our results support Stenqvist et al's view that satisfactory positive pressure ventilation can be performed using tubes of 6-6.5 mm i.d. [1]. There was a statistically significant rise in peak inspiratory pressure at the proximal end of the tube in the small tube groups, but the absolute values were not large and probably clinically insignificant.…”

“…It might be supposed that the size of tracheal tube best suited to adult men and women would be a matter of general agreement. Stenqvist et al measured ventilator and intratracheal pressures during positive pressure ventilation of patients whose tracheas were intubated with different sizes of tracheal tube and found that ventilator pressures were only slightly raised and intratracheal pressures were not raised when the tracheal tube size was decreased from 9.0 mm to 6.0 mm [1]. They concluded that positive pressure ventilation could be achieved with the use of small sizes of tracheal tube.…”