Uncuffed Endotracheal Tubes: Not Appropriate for Pediatric Critical Care Transport

Pearson, Thomas E.; Frizzola, Meg; Khine, Henry H.

doi:10.1016/j.amj.2018.10.002

Cited by 9 publications

(5 citation statements)

References 15 publications

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“…One retrospective cohort study compared the use of cuffed and uncuffed endotracheal tubes in the transfer setting. [9] The main results of the study are shown in Figure 6. In this study of pediatric patients with a tracheal tube requiring inter-facility transport, 24 of 55 patients with uncuffed tracheal tubes required a tube change after arrival, whereas no patients with cuffed tubes (n = 158) required a tube change.…”

Section: Resultsmentioning

confidence: 99%

“…We then reviewed the full text of the remaining 27 studies and finally identified 4 studies that met the selection criteria, including 1 RCT [6] and 3 observational studies. [7][8][9] Figure 1 shows the Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram of the study selection process. Four studies were related to the use of continuous blood pressure monitoring, [6] ECMO, [7] pelvic circumferential compression devices (PCCDs), [8] and cuffed tracheal tubes.…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

“…Four studies were related to the use of continuous blood pressure monitoring, [6] ECMO, [7] pelvic circumferential compression devices (PCCDs), [8] and cuffed tracheal tubes. [9] Table 1 summarizes the characteristics of the included studies. We did not perform a meta-analysis because the 4 studies dealt with different devices.…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

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Medical equipment that improve safety and outcomes of inter-facility transportation of critically ill patients: A systematic review

et al. 2023

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Background: Although many critically ill patients require inter-facility transport for definitive or specialized therapy, the medical equipment required to enhance transport safety remains unclear. This review was performed to summarize the evidence regarding devices used to improve the safety and survival in patients requiring such transport. Methods: We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi for randomized controlled trials and observational studies comparing outcomes according to the presence or absence of devices (or new vs conventional devices) during transfer of critically ill patients. Results: Four studies focusing on continuous blood pressure monitoring, extracorporeal membrane oxygenation, pelvic circumferential compression devices, and cuffed tracheal tubes, respectively, met the inclusion criteria. A meta-analysis was not performed because the 4 studies focused on different devices. Near-continuous blood pressure monitoring increased interventions such as intravenous fluid administration during transport, shortened the intensive care unit and hospital lengths of stay, and reduced the incidence of multiple-organ failure compared with use of oscillometric devices. Despite the small sample size and varying severity of illness among the groups, transport of patients with severe respiratory failure under extracorporeal membrane oxygenation resulted in fewer hypoxemic events during transport than transport on conventional ventilators. During transport of patients with pelvic fractures, pelvic belts may help to reduce mortality and the transfusion volume. Cuffed (vs uncuffed) tracheal tubes may reduce post-transport tube replacement events in pediatric patients. Conclusion: Studies on devices needed for inter-facility transport of critically ill patients are scarce, but some devices may be beneficial.

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Section: Resultsmentioning

confidence: 99%

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

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Medical equipment that improve safety and outcomes of inter-facility transportation of critically ill patients: A systematic review

et al. 2023

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“…Inadequate ventilation through uncuffed tracheal tubes has been reported outside the operating theatre. A retrospective case review of 213 children referred to a paediatric critical retrieval service over a 3‐year period observed that inadequate ventilation more often triggered repeat laryngoscopy and urgent tracheal tube replacement in children intubated with an uncuffed tube: no cuffed tubes required replacement . The UK Resuscitation Council advocates that the trachea of infants and children (but not neonates) should be intubated with appropriately‐sized cuffed tubes by trained staff, with monitoring of cuff pressure and confirmation of tube placement .…”

Section: Does the Evidence Support Increased Use Of Cuffed Tubes?mentioning

confidence: 99%

Cuffed tracheal tubes: guilty now proven innocent

Shah

Carlisle

2019

Anaesthesia

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“…9,10 The use of uncuffed tracheal tubes is associated with a significant increase in the number of intubation attempts required to form an adequate seal to allow effective ventilation. 11 In a recent study examining the use of uncuffed tracheal tubes in critically ill children, their use resulted in nearly half of the patients requiring urgent reintubation with a cuffed tracheal tube 12 to provide adequate ventilation.…”

mentioning

confidence: 99%