N Engl J Med 2014;370:e4. DOI: 10.1056/NEJMvcm1300964 Copyright © 2014 Massachusetts Medical Society. Overview Endotracheal extubation refers to the removal of an endotracheal tube from the trachea. This procedure is commonly performed in operating rooms, postanesthesia care units, and intensive care units. This review focuses on extubation of the trachea after general anesthesia and short-term...

In the absence of infection, the pathophysiology of endotracheal tube-induced sore throat pain is unclear. Activated neutrophils release elastase, reactive oxygen species, and inflammatory cytokines known to contribute to neuropathic pain. Sterile tissue injury can cause the release of damage-associated molecular patterns such as mitochondrial DNA that promote neutrophil activation. We hypothes...

We report the case ofa pediatric patient with tetralogy of Fallot (TOF) and cleft palate deformity with difficult intubation in which a laryngeal mask airway (LMA) was used and converted into an endotracheal tube through retrograde intubation. The patient with TOF was scheduled for repair of the congenital bilateral cleft lip and palate. Inhalational induction with 4% sevoflurane was started. C...

1. The small flexible suction catheter they inserted through the endotracheal tube stopped at 19 cm, the point at which the pilot balloon line inserts, i.e., where the cuff is starting to inflate. Did the authors attempt to let the cuff down? This should be considered as the first option for a possible treatment of an airway obstruction. The cuff could have herniated into the lumen of the endot...

STUDY OBJECTIVE To investigate safety issues associated with the reuse of sterilized endotracheal tubes (ETTs). DESIGN Prospective, randomized study. SETTING Laboratory in vivo testing. INTERVENTION Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were inoculated onto ETT cuffs. Following inoculation, ETTs were sterilized with either ethylene oxide or glutaraldehyde. Cu...

OBJECTIVE To evaluate the utility of endotracheal aspirate microscopy, culture and endotracheal tube tip culture for early diagnosis of ventilator-associated pneumonia in neonates. METHODS Inborn ventilated neonates were followed-up for ventilator-associated pneumonia using Center for Disease Control and Prevention (CDC) criteria. Endotracheal aspirate microscopy, culture and endotracheal tub...

This study aimed to determine molecular patterns of Acinetobacter baumannii using a PCR-based technique with REP-1, REP-2 and M13 primers to distinguish the patients' strains and the environmental strains (condensate, endotracheal tube connector, bed rail and nurses hands). There were 67 cases of ventilator-associated pneumonia (VAP) among 600 patients using mechanical ventilators in 10 wards f...

Waveform capnography was recommended as the most reliable method to confirm correct endotracheal tube or laryngeal mask airway placements. However, capnography may be unreliable during cardiopulmonary resuscitation and during low flow states. It may lead to an unnecessary removal of a well-placed endotracheal tube, re-intubation and interruption of chest compressions. Real-time upper airway (la...

BACKGROUND Endotracheal Tubes (ETTs) are commonly secured using adhesive tape, cloth tape, or commercial devices. The objectives of the study were (1) To compare degrees of movement of ETTs secured with 6 different commercial devices and (2) To compare movement of ETTs secured with cloth tape tied with 3 different knots (hitches). METHODS A 17 cm diameter PVC tube with 14 mm "mouth" hole in t...

BACKGROUND This study aimed at correlating anatomical dimensions of the larynx and trachea to age and weight in a prenatal population. Endotracheal tube size determination was then proposed according to these considerations. METHODS Anatomical measurements were obtained during 150 fetal and infant postmortem examinations. The optimal endotracheal tube size was determined by three methods: cli...