Tracheostomy can influence the work of breathing by introducing additional resistance to airflow through the native airway. In a 1996 study, Hussey and Bishop determined that the presence of a deflated cuff in the airway significantly increased the work of breathing and theorized that a lower profile cuff would introduce less resistance to airflow. Hussey and Bishop also demonstrated that the p...

Whether cuffed tubes should be routinely used in infants and small children has been extensively discussed in the past. However, opinions and recommendations were not based on scientific evidence but rather on empiricism. The basic function of a tracheal tube is to provide a reliable connection between the patient’s lung and the bag or ventilator. Ideally, this connection should be leak-proof w...

BACKGROUND To assess the adequacy of the position of the tracheal tube cuff and tracheal tube tip in the recently introduced preformed oral Microcuff paediatric endotracheal tube (PET) using the manufacturers recommendations for Microcuff tracheal tube size selection. METHODS With Hospital Ethics Committee approval and informed parental consent, the tracheas of children from birth to adolesce...

The dimensions of tracheal tubes and connectors in common use were measured together with the resistance to breathing at flow rates occurring in babies breathing quietly. The outside diameters of rubber tubes varied more than those of plastic tubes. The main factors influencing resistance were the internal diameter and a sudden change in diameter or direction of flow. These are of particular im...

BACKGROUND The air-Q Intubating Laryngeal Airway (ILA) (Cookgas LLC, Mercury Medical, Clearwater, FL) is a supraglottic airway device available in pediatric sizes, with design features to facilitate passage of cuffed tracheal tubes when used to guide tracheal intubation. We designed this prospective observational study of the ILA to assess the ease of its placement in paralyzed pediatric patien...

BACKGROUND In trauma patients intubated in a physician-led pre-hospital trauma service we prospectively examined the rate of misplaced tracheal tubes, the presence and nature of gross airway contamination, and the value of 'quick look' airway assessment to identify patients with subsequent difficult laryngoscopy. METHODS Patients requiring pre-hospital intubation in a 16 month period were inc...

undergoing abdominal surgery. After animal use committee approval, 14 pigs were anaesthetized and the tracheas intubated with appropriately sized Hi-Lo Evac (n1⁄47) or TaperGuard Evac (n1⁄47) tracheal tubes. Saline based-fluid (pH 2.5/0.3 ml kg) stained with Methylene-Blue was instilled into the area below the vocal cords but above the inflated tracheal tube cuff via the Evac port. The cuff pre...