Cuffed tracheal tube
Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction.
The most widely used route is orotracheal, in which an endotracheal tube is passed through the mouth and vocal apparatus into the trachea. In a nasotracheal procedure, an endotracheal tube is passed through the nose and vocal apparatus into the trachea. Other methods of intubation involve surgery and include the cricothyrotomy (used almost exclusively in emergency circumstances) and the tracheotomy, used primarily in situations where a prolonged need for airway support is anticipated.
Because it is an invasive and extremely uncomfortable medical procedure, intubation is usually performed after administration of general anesthesia and a neuromuscular-blocking drug. It can however be performed in the awake patient with local or topical anesthesia, or in an emergency without any anesthesia at all. Intubation is normally facilitated by using a conventional laryngoscope, flexible fiberoptic bronchoscope or video laryngoscope to identify the glottis, though other devices and techniques are available.
After the trachea has been intubated, a balloon cuff is typically inflated just above the far end of the tube to help secure it in place, to prevent leakage of respiratory gases, and to protect the tracheobronchial tree from receiving undesirable material such as stomach acid. The tube is then secured to the face or neck and connected to a T-piece, anesthesia breathing circuit, bag valve mask device, or a mechanical ventilator.
Once there is no longer a need for ventilatory assistance and/or protection of the airway, the tracheal tube is removed; this is referred to as extubation of the trachea (or decannulation, in the case of a surgical airway such as a cricothyrotomy or a tracheotomy).
For centuries, tracheotomy was considered the only reliable method for intubation of the trachea. However, because only a minority of patients survived the operation, physicians undertook tracheotomy only as a last resort, on patients who were nearly dead. It was not until the late 19th century however that advances in understanding of anatomy and physiology, as well an appreciation of the germ theory of disease, had improved the outcome of this operation to the point that it could be considered an acceptable treatment option.
Also at that time, advances in endoscopic instrumentation had improved to such a degree that direct laryngoscopy had become a viable means to secure the airway by the non-surgical orotracheal route. By the mid-20th century, the tracheotomy as well as endoscopy and non-surgical tracheal intubation had evolved from rarely employed procedures to becoming essential components of the practices of anesthesiology, critical care medicine, emergency medicine, gastroenterology, laryngology, pulmonology and surgery.
Tracheal intubation can be associated with minor complications such as broken teeth or lacerations of the tissues of the upper airway. It can also be associated with potentially fatal complications such as pulmonary aspiration of stomach contents which can result in a severe and sometimes fatal chemical aspiration pneumonitis, or unrecognized intubation of the esophagus which can lead to potentially fatal anoxia. Because of this, the potential for difficulty or complications due to the presence of unusual airway anatomy or other uncontrolled variables is carefully evaluated before undertaking tracheal intubation. Alternative strategies for securing the airway must always be readily available.

This is an excerpt from the article Cuffed tracheal tube from the Wikipedia free encyclopedia. A list of authors is available at Wikipedia.
The article Cuffed tracheal tube at en.wikipedia.org was accessed 8 times in the last 30 days. (as of: 11/21/2013)
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Pediatric Cuffed Endotracheal Tubes: An…
The initial studies of the larynx of infants and children were conducted on cadaveric specimens,3-,5 and these findings have informed our airway management.
www.ncbi.nlm.nih.gov/pmc/articles/PMC3096176/
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Types of Tracheostomy Tubes - Johns Hopkins Medicine
A tracheostomy (trach) tube is a curved tube that is inserted into a ... CuffedTube with Disposable Inner Cannula ... Fenestrated Cuffed Tracheostomy Tube.
www.hopkinsmedicine.org/tracheostomy/about/types.html
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Tracheal tube - Wikipedia, the free encyclopedia
Diagram of an endotracheal tube that has been inserted into the trachea: A - endotracheal ... A typical cuffed endotracheal tube, constructed of polyvinyl chloride.
en.wikipedia.org/wiki/Tracheal_tube
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Finally, a cuffed ET tube designed for the pediatric anatomy.
Pediatric Endotracheal Tube. Common Concerns with Pediatric Endotracheal Tubes ... the safe placement of a Cuffed tracheal tube in children from a wide age  ...
kchealthcare.com/media/74430/microcuff%20brochure_pediatric_h8346_final.pdf
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Uncuffed vs. Cuffed Endotracheal Tubes - The Society for Pediatric ...
Uncuffed versus Cuffed Endotracheal Tubes. Markus Weiss, MD, Zurich, Switzerland. During the last five decades, unCuffed tracheal tubes were recommended ...
www.pedsanesthesia.org/meetings/2007annual/syllabus/Faculty_Manuscripts/Weiss-Uncuffed%20versus%20cuffed.pdf
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Tracheostomy Care - Cleveland Clinic
They may have an inner cannula that is either disposable or reusable. The tracheostomy tube may or may not have a cuff. Cuffed trach tubes are generally used ...
my.clevelandclinic.org/head-neck/treatments-services/tracheostomy-care.aspx
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Endotracheal Tubes | Basic Endotracheal Airways | Covidien RMS
Mallinckrodt™ Hi−Lo Oral/Nasal Tracheal Tube Cuffed Intermediate, Murphy Eye and Pre-Cut. Excellent for oral and nasal intubations where a shorter cuff is ...
covidien.com/rms/products/basic-endotracheal-airways
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Mallinckrodt Endotracheal Tubes from Covidien
The Mallinckrodt Hi-Lo oral/nasal tracheal tube cuffed murphy eye has a thin cuff that conforms to uneven tracheal surfaces to create a low-pressure seal.
covidien.com/rms/brands/mallinckrodt
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Use of the Cuffed Tracheostomy Tube - JStor
When the patient in acute respiratory failure requires assisted ventilation, a cuffed tracheostomy tube usually provides the airway. The tracheal end of this tube is ...
www.jstor.org/stable/3420474
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Endotracheal Tubes - Medscape Reference
Jan 11, 2012 ... Category. Endotracheal tubes. An image of an endotracheal tube can be seen below. Cuffed endotracheal tube. Next ...
emedicine.medscape.com/article/2044750-overview
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Cuffed tracheal tube in science
Comparison of the i-gel with the cuffed tracheal tube during pressure ...
... Pain and Critical Care, Faculty of Medicine, University of Glasgow, Level 2, QEB ... the gas leaks and comparing these values with that of the tracheal tube.
[PDF]Tracheostomy Care - UPMC.com
ration with the respiratory care nurses and therapists across the University of .... cuff. 5. 15mm connector - part of the tracheostomy tube or inner cannula that ...
Tracheostomy Tube Change - Medscape Reference
Dec 17, 2013 ... Obturator, inner cannula, cuffed tracheostomy tube, and .... Canares, MD, and Jonathan Valente, MD, Rhode Island Hospital, Brown University.
Cuffed Inner Cannula and Flexible Outer Cannula Tracheostomy Tube
Sep 18, 2012 ... Summary. During any procedure in which a tracheostomy tube is fully removed from the artificially created airway, there is a chance of losing ...
Outer diameter and shape of paediatric tracheal tube cuffs at higher ...
Department of Neonatology and Intensive Care Medicine, University Children's Hospital ... Cuffed tracheal tubes are becoming increasingly popular in paediatric  ...
Cuffed endotracheal tube use in paediatric prehospital intubation ...
R S Clements, MAGPAS and Basildon and Thurrock University Hospitals NHS ... The use of cuffed endotracheal tubes (ETTs) in pre‐pubertal children is ...
Shortcomings of cuffed paediatric tracheal tubes.
... of Otorhinolaryngology, University Children's Hospital, Steinwiesstrasse 75, ... METHODS: In 15 series of cuffed (11) and uncuffed (four) paediatric tracheal tubes ... Placing the tube tip in the mid-trachea, the cuffs of cuffed tubes with ID 3.0, ...
"Cuffed Versus Uncuffed Tracheal Tubes in Small Children" - Full ...
Sep 13, 2005 ... Further study details as provided by University Children's Hospital, ... The use of Cuffed tracheal tubes is a controversial topic in paediatric ...
[PDF]Cuffed tracheal tubes in children - Rileyanesthesia.org
Cuffed tracheal tubes in children – things have changed. MARKUS WEISS MD AND ANDREAS C. GERBER MD. Department of Anaesthesia, University ...
[PDF]New Advances in Pediatric Ventilation - Kimberly-Clark Health Care
clinical experiences using a new cuffed endotracheal tube. Increased .... Endotracheal. Anaesthesia, Third Edition. University of Wisconsin Press. 1963.
Books on the term Cuffed tracheal tube
A Practice of Anesthesia for Infants and Children: Expert ...
A Practice of Anesthesia for Infants and Children: Expert ...
2013
Should cuffed endotracheal tubes be used routinely in children? Can J Anaesth 2005;52:669-74. Weiss M, Gerber AC. Cuffed tracheal tubes in children+things have changed. Paediatr Anaesth 2006;16:1005—7. Khine HH, Corddry DH, ...
Morgan and Mikhail's Clinical Anesthesiology, 5th edition (Lange Medical Books)
Morgan and Mikhail's Clinical Anesthesiology, 5th edition (Lange Medical Books)
John Butterworth, David C. Mackey and John Wasnick, 2013
The most user-friendly, clinically relevant overview of the practice of anesthesiology Current, concise, and engagingly written, Morgan & Mikhail’s Clinical Anesthesiology, Fifth Edition is a true essential for all anesthesia students and practitioners. This trusted classic delivers comprehensive coverage of the field’s must-know basic science ...
Children with Tracheostomies: Resource Guide
Children with Tracheostomies: Resource Guide
Marilyn Kertoy, 2002
Trachea Hub Neck plate Cannula Figure 1-2 Display of outer tracheal tube, hub, and neck plate situated in a child. ... Cuffed tracheostomy tubes are used infrequently in children because of the risk of damage to the developing trachea; thus ...
CURRENT Diagnosis and Treatment Pediatrics, Twenty-First Edition (Current Pediatric Diagnosis & Treatment)
CURRENT Diagnosis and Treatment Pediatrics, Twenty-First Edition (Current Pediatric Diagnosis & Treatment)
William Hay, Myron Levin, Robin Deterding and Mark Abzug, 2012
Evidence-based information on the care of children from birth through adolescence in an easy-to-use, find-it-now presentation CURRENT Diagnosis & Treatment Pediatrics, 21e delivers concise, up-to-date, and clinically relevant coverage of how to assess and treat common disorders in children. Known as the on-the-go guide to pediatrics, the book f...
Hatch & Sumner's Textbook of Paediatric Anaesthesia Third ...
Hatch & Sumner's Textbook of Paediatric Anaesthesia Third ...
Robert Bingham, Adrian Lloyd Thomas, M Sury, 2007
A standard tracheal tube, round in cross-section and small enough to fit through the narrowest part of the glottis, will have a ... In a French postal survey on the use of cuffed and unCuffed tracheal tubes in infants and children, 25 per cent of ...
Roberts and Hedges' Clinical Procedures in Emergency Medicine: Expert Consult - Online and Print, 6e (Roberts,...
Roberts and Hedges' Clinical Procedures in Emergency Medicine: Expert Consult - Online and Print, 6e (Roberts,...
James R. Roberts MD FACEP FAAEM FACMT, 2013
Roberts and Hedges' Clinical Procedures in Emergency Medicine continues its long tradition of being the most well-known and trusted procedures manual in emergency medicine. The newly revised 6th edition of this classic medical reference has been thoroughly updated with step-by-step Review, Procedure, and Ultrasound Boxes covering the latest eq...
Case-Based Anesthesia: Clinical Learning Guides
Case-Based Anesthesia: Clinical Learning Guides
Stephen F. Dierdorf, Gabriella Iohom, Christopher J. O'Connor, 2009
Positive pressure ventilation demonstrated a large leak around the tracheal tube (1 2 cm water [H2O]). The tracheal tube was replaced with a 6.0- cuffed orotracheal tube; 3 mL of air injected into the pilot balloon produced an air seal.
Basics of Anesthesia: Expert Consult - Online and Print, 6e (Expert Consult Title: Online + Print)
Basics of Anesthesia: Expert Consult - Online and Print, 6e (Expert Consult Title: Online + Print)
Ronald D. Miller MD and Manuel Pardo MD, 2011
With the most authoritative and complete overview of anesthesia theory and practice, the latest edition of Basic Anesthesia, edited by noted anesthesiologist Ronald D. Miller, MD and Manuel C. Pardo, Jr., MD, continues to serve as an excellent primer on the scope and practice of anesthesiology. Widely acknowledged as the foremost introductory text,...
Basics of Pediatric Anesthesia
Basics of Pediatric Anesthesia
Ronald S. Litman, 2013
Furthermore, since spontaneous ventilation in intubated children is not usually performed, the increased resistance of the slightly smaller internal diameter tube will not increase work of breathing. Use of a cuffed endotracheal tube will prevent  ...
Introduction To Basic Cardiac Dysrhythmias
Introduction To Basic Cardiac Dysrhythmias
Sandra Atwood, Cheryl Stanton and Jenny Storey-Davenport, 2013
Written in a clear, easy-to-understand style, Introduction to Basic Cardiac Dysrhythmias, Revised Fourth Edition, uses straightforward language to explain how the heart functions and how to interpret ECGs–essential knowledge that will allow you to anticipate the appropriate treatment for each. Coverage of the 2010 Emergency Cardiovascular Care guid...
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Blog posts on the term
Cuffed tracheal tube
SJTREM | Full text | Prospective observational study on tracheal tube cuff pressures in emergency patients¿ is neglecting the problem the problem?
Inappropriately Cuffed tracheal tubes can lead to inadequate ventilation or silent aspiration, or to serious tracheal damage. Cuff pressures are of particular importance during aeromedical transport as they increase due to decreased atmospheric pressure at flight level. We hypothesised, that cuff pressures are frequently too high in emergency and critically ill patients but are dependent on providers’ professional background.
www.sjtrem.com/content/21/1/83
Endotracheal tube cuffs: why do they leak and how can they be fixed?
aa2day.org/2013/08/cuff/
Blom Tracheostomy Tube
www.everythingspeech.com/articles/blom-tracheostomy-tube/
Impact of a Low-Pressure Polyurethane Adult Endotracheal Tube on the Incidence of Ventilator-Associated Pneumonia: A before and after Concurrence Study
ISRN Critical Care is a peer-reviewed, open access journal that publishes original research articles, review articles, and clinical studies in all areas of critical care.
www.hindawi.com/isrn/critical.care/2013/812964/
Medical News: Efficiency of a pneumatic device in controlling cuff pressure of polyurethane-cuffed tracheal tubes: a randomized controlled study
medical2news.blogspot.com/2013/12/efficiency-of-pneumatic-device-in.html
Critical Care | Full text | New tracheal tubes to prevent ventilator-associated pneumonia: where is the evidence?
NA
ccforum.com/content/15/6/459/
Why We Do What We Do: Cuffed Tubes versus Uncuffed Tubes in Pediatrics | Jacobi Emergency Medicine
jacobiem.org/why-we-do-what-we-do-cuffed-tubes-versus-uncuffed-tubes-in-pediatrics/
ORIGINAL ARTICLE – Does intra-cuff alkalinized lidocaine prevent tracheal tube induced emergence phenomena in children? | Anaesthesia, Pain & Intensive Care
www.apicareonline.com/?p=1740
Kids tracheal tubes – formulas galore | Resus M.E!
An ultrasound study of paediatric airways showed sonographic measurement to be a better predictor of tracheal tube size (using a formula - derived and then
resus.me/kids-tracheal-tubes-formulas-galore/
Annals of Intensive Care | Full text | Effect of tracheal suctioning on aspiration past the tracheal tube cuff in mechanically ventilated patients
This clinical study evaluated the effect of a suctioning maneuver on aspiration past the cuff during mechanical ventilation.
www.annalsofintensivecare.com/content/2/1/45
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