The use of cuffed tracheal tubes in paediatric patients: a survey of practice of anaesthetists in Ireland

Background Traditionally, non-cuffed tubes have been used for tracheal intubation of children under eleven years of age. The evidence is now strongly supportive of cuffed tubes in this population. Objectives We aimed to ascertain the patterns of tracheal tube usage in paediatric anaesthesia in Ireland. Materials and methods A self-structured questionnaire was distributed at anaesthesia conferences and departments in Ireland between March and August 2012 (n = 231). Results 75% of the 231 respondents routinely used non-cuffed tracheal tubes in these children. Emergency procedures in unfasted children, obesity and planned laparoscopy influenced anaesthetists to use a cuffed rather than a non-cuffed tube(p <0.001). 66% of respondents were unsure if they would use a high-volume low-pressure cuff. Compared to anaesthetists with proportionately lesser paediatric workloads, those with greater paediatric workloads were inclined to use a cuffed tracheal tube with a high-volume low-pressure cuff(p<0.01). Conclusion We concluded that despite plentiful data supporting the use of cuffed tracheal tubes in children their rate of use is low amongst anaesthetists in Ireland. There is considerable uncertainty regarding high-volume low-pressure cuffed tubes.