Work of breathing for cuffed and uncuffed pediatric endotracheal tubes in an in vitro lung model setting

Paediatric Anaesthesia
Jörg ThomasAlexander R Schmidt

Abstract

Over the last decade, cuffed endotracheal tubes are increasingly used in pediatric anesthesia and also in pediatric intensive care. However, the smaller inner diameter of cuffed endotracheal tubes and, implicitly, the increased endotracheal tube resistance is still a matter of debate. This in vitro study investigated work of breathing and inspiratory airway pressures in cuffed and uncuffed endotracheal tubes and the impact of pressure support ventilation and automatic tube compensation. In 5 simulated neonatal and pediatric lung models, the Active Servo Lung 5000 and an intensive care ventilator were used to quantify the differences in work of breathing under spontaneous breathing (with and without pressure support ventilation and automatic tube compensation) between cuffed and uncuffed endotracheal tubes. Additionally, differences in inspiratory airway pressures, measured either proximal or distal of the endotracheal tube, between cuffed and uncuffed endotracheal tubes under mechanical ventilation were investigated. Work of breathing was overall 10.27% [95% confidence interval 9.01-11.94] higher with cuffed than with uncuffed endotracheal tubes and was dramatically reduced by 34.19% [95% confidence interval 31.61-35.25] with t...Continue Reading

References

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Citations

Jul 18, 2019·Anaesthesia·A Shah, J B Carlisle
Aug 10, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Donald H ShaffnerJamie McElrath Schwartz
May 29, 2020·BioMed Research International·Sema Şanal BaşYeliz Kılıç
Oct 28, 2019·Clinics in Perinatology·Raymond S ParkPete G Kovatsis

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