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1

Dbouk, Talib, and Dimitris Drikakis. "Endotracheal Tubes Design: The Role of Tube Bending." Symmetry 13, no. 8 (2021): 1503. http://dx.doi.org/10.3390/sym13081503.

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Endotracheal tubes (ETT) passed inside the human trachea witness tube bending at different angles, affecting the local fluid flow dynamics. This induces a variable mechanical ventilation performance across patients’ comfortability levels. Our understanding of the local fluid flow dynamics phenomena is thus crucial to enhance the maneuverability of ETT under operation. For the first time to our knowledge, we shed light on ETT through computational fluid dynamics (CFD) to investigate the bending effect of ETT on the local airflow in volume-controlled mechanical ventilation. We considered an ETT
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Berra, Lorenzo, Lorenzo De Marchi, Zu-Xi Yu, Patrice Laquerriere, Andrea Baccarelli, and Theodor Kolobow. "Endotracheal Tubes Coated with Antiseptics Decrease Bacterial Colonization of the Ventilator Circuits, Lungs, and Endotracheal Tube." Anesthesiology 100, no. 6 (2004): 1446–56. http://dx.doi.org/10.1097/00000542-200406000-00017.

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Background Formation of a bacterial biofilm within the endotracheal tube (ETT) after tracheal intubation is rapid and represents a ready source of lung bacterial colonization. The authors investigated bacterial colonization of the ventilator circuit, the ETT, and the lungs when the ETT was coated with silver-sulfadiazine and chlorhexidine in polyurethane, using no bacterial/viral filter attached to the ETT. Methods Sixteen sheep were randomized into two groups. Eight sheep were intubated with a standard ETT (control group), and eight were intubated with a coated ETT (study group). Animals were
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Santos, Perry M., Ali Afrassiabi, and Ernest A. Weymuller. "Prospective Studies Evaluating the Standard Endotracheal Tube and a Prototype Endotracheal Tube." Annals of Otology, Rhinology & Laryngology 98, no. 12 (1989): 935–40. http://dx.doi.org/10.1177/000348948909801204.

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Two prospective studies were designed to evaluate laryngeal injury sustained with the standard endotracheal tube (ETT) and the relative safety of a new prototype ETT. The first study followed patients after prolonged intubation with the standard ETT. Potential patient host factors were recorded and correlated with subjective complaints and objective findings on fiberoptic laryngoscopy. Nearly all patients sustained laryngeal injury after prolonged intubation, although over two thirds experienced resolution. Nasogastric feeding tubes and larger-diameter ETTs were associated with true vocal cord
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Yim, A., J. Doctor, S. Aribindi, and L. Ranasinghe. "Cuffed vs Uncuffed Endotracheal Tubes for Pediatric Patients: A Review." Asploro Journal of Biomedical and Clinical Case Reports 4, no. 1 (2021): 50–53. https://doi.org/10.36502/2021/ASJBCCR.6228.

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The use of uncuffed endotracheal tubes (ETT) in patients younger than 8 years old has been in practice for the last 60 years. In the last decade, there has been a change in clinical practice with a transition to cuffed ETT use, and there continues to be debate between cuffed vs uncuffed ETT use. This narrative review article aims to review the current literature on the topic and highlight some key points in the argument of cuffed vs uncuffed ETT use in pediatric patients. Cuffed ETTs are increasingly being used with several studies over the last 20 years demonstrating its benefits. Studies hav
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A, Yim, Doctor J, Aribindi S, and Ranasinghe L. "Cuffed vs Uncuffed Endotracheal Tubes for Pediatric Patients: A Review." Asploro Journal of Biomedical and Clinical Case Reports 4, no. 1 (2021): 50–53. http://dx.doi.org/10.36502/2021/asjbccr.6228.

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The use of uncuffed endotracheal tubes (ETT) in patients younger than 8 years old has been in practice for the last 60 years. In the last decade, there has been a change in clinical practice with a transition to cuffed ETT use, and there continues to be debate between cuffed vs uncuffed ETT use. This narrative review article aims to review the current literature on the topic and highlight some key points in the argument of cuffed vs uncuffed ETT use in pediatric patients. Cuffed ETTs are increasingly being used with several studies over the last 20 years demonstrating its benefits. Studies hav
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Waters, Christopher, R. Constance Wiener, and Hamed M. Motlagh. "Ex VivoEvaluation of Secretion-Clearing Device in Reducing Airway Resistance within Endotracheal Tubes." Critical Care Research and Practice 2018 (December 10, 2018): 1–7. http://dx.doi.org/10.1155/2018/3258396.

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Background. Secretions accumulate in endotracheal tubes’ (ETT) lumens upon their placement in patients. The secretions impact airway resistance and pressure. Secretions potentiate prolonged mechanical ventilation and ventilator-associated pneumonia. Our primary objective in this study was to evaluate an ETT-clearing device (ETT-CD) in its ability to remove secretions fromex vivoETT lumens.Methods. Forty ETTs, obtained from intensive care patients at extubation, were individually placed into a ventilator field performance testing simulator at 37°C. The pressure drop through the ETTs was measure
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Shibasaki, Masayuki, Yasufumi Nakajima, Sachiyo Ishii, Fumihiro Shimizu, Nobuaki Shime, and Daniel I. Sessler. "Prediction of Pediatric Endotracheal Tube Size by Ultrasonography." Anesthesiology 113, no. 4 (2010): 819–24. http://dx.doi.org/10.1097/aln.0b013e3181ef6757.

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Background Formulas based on age and height often fail to reliably predict the proper endotracheal tube (ETT) size in pediatric patients. We, thus, tested the hypothesis that subglottic diameter, as determined by ultrasonography, better predicts optimal ETT size than existing methods. Methods A total of 192 patients, aged 1 month to 6 yr, who were scheduled for surgery and undergoing general anesthesia were enrolled and divided into development and validation phases. In the development group, the optimal ETT size was selected according to standard age-based formulas for cuffed and uncuffed tub
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Gavriely, N., J. Solway, S. H. Loring, J. P. Butler, A. S. Slutsky, and J. M. Drazen. "Pressure-flow relationships of endotracheal tubes during high-frequency ventilation." Journal of Applied Physiology 59, no. 1 (1985): 3–11. http://dx.doi.org/10.1152/jappl.1985.59.1.3.

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We studied the pressure-flow relationships of various endotracheal tubes (ETT) at frequencies (f) and tidal volumes (VT) in the range used for high-frequency ventilation (HFV) (f: 2–32 Hz, VT: 15–100 ml). Sinusoidal flows were applied to ETT inserted into a rigid bottle or into the tracheae of three anesthetized paralyzed dogs, while pressure fluctuations were measured both proximal and distal to the ETT. The pressure drops in the ETT were nonlinearly related to the peak flow rate and were VT dependent, suggesting that turbulent frictional head loss and convective acceleration were important.
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9

Wickberg, Maria, and Ann-Charlotte Falk. "The occurrence of pressure damage in the oral cavity caused by endotracheal tubes." Nordic Journal of Nursing Research 37, no. 1 (2016): 2–6. http://dx.doi.org/10.1177/2057158516656109.

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The aim of this observational study was to investigate the occurrence of pressure damage caused by endotracheal tubes (ETT) when the tube is repositioned from one corner of the mouth to the other every third day. For the assessment of oral condition and the eventual damage caused by ETT, a modified version of the Oral Assessment Guide (OAG) was used. The oral condition was assessed once per day in all adult patients who were orally intubated with a tube for over 24 hours. Thirty-eight patients were included in the study. Most patients ( n = 33, 86.8%) had no pressure damage. Five patients (13.
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Vinit, Kumar, Hansda Priyanka, Kumar Pawan, Kumar Mrityuanjay, and D. Ram C. "A Questionnaire-Based Assessment of the Use of Cuffed Endotracheal Tubes in Paediatric Anaesthesia amongst Indian Anaesthesiologists." International Journal of Current Pharmaceutical Review and Research 15, no. 03 (2023): 188–94. https://doi.org/10.5281/zenodo.12651331.

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Aim: The aim of the present study was to understand the current practices regarding the useof cuffed endotracheal tubes in paediatric anaesthesia amongst Indian anaesthesiologists.Methods: The present study was conducted at department of Anesthesiology, SNMMCH,Dhanbad, Jharkhand, India for one year and we formulated a questionnaire intended to assessthe use of cuffed endotracheal tubes in pediatric age-group by pediatric and generalanaesthetics in India. The questionnaire was also designed to evaluate practices related to theuse of cuffed endotracheal tube in pediatric age group, such as the m
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11

Arul, Harshan, Anitha Shenoy, and Jasvinder Kaur. "A comparative study of paediatric endotracheal tubes available in the Indian market – a bench study." Indian Journal of Respiratory Care 03, no. 02 (2022): 431–39. http://dx.doi.org/10.5005/ijrc-3-1-431.

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Introduction: A variety of paediatric endotracheal tubes (ETT) are available in India. Aim: Comparison of paediatric cuffed and uncuffed ETT with respect to dimensions, depth markings, cuff characteristics and cost. Methods: 65 cuffed and 38 uncuffed paediatric ETT (3.0-7.0 mm ID) from 12 different manufacturers were evaluated. The outer diameter, position of depth markings, length and position of cuff, largest diameter of cuff inflated at 20 cm H2O of the ETTs were measured and compared with dimensions of trachea. Results: Outer diameters of similar ID ETTs varied between manufacturers and be
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12

Fernández-Barat, Laia, Ruben López-Aladid, Nil Vázquez, et al. "Bacterial Adaptive Memory in Methicillin-Resistant Staphylococcus aureus from Endotracheal Tubes." Pathogens 13, no. 2 (2024): 144. http://dx.doi.org/10.3390/pathogens13020144.

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Objectives: To evaluate the expression dynamics of biofilm genes in methicillin-resistant Staphylococcus aureus (MRSA) retrieved from endotracheal tubes (ETT) and to determine how gene regulation is attenuated in vitro where host–environmental factors are no longer present. Methods: Biofilm was grown (24 h) in tryptic broth soy plus 0.25% glucose for a clinical MRSA isolate in planktonic state and after sessile growth named ETT-MRSA (S2, S3, S4, S5, S6, S7). Gene expression of five biofilm-related genes (icaC, clfB, ebps, fnbB, and RNA III) was assessed consecutively from day 1 to day 4 after
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13

Ahrens, Richard C., Rebecca A. Ries, and Miles Weinberger. "1724 PENETRATION OF THERAPEUTIC AEROSOLS (TA) THROUGH ENDOTRACHEAL TUBES (ETT)." Pediatric Research 19, no. 4 (1985): 398A. http://dx.doi.org/10.1203/00006450-198504000-01742.

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Markovetz, Matthew R., Durai B. Subramani, William J. Kissner, et al. "Endotracheal tube mucus as a source of airway mucus for rheological study." American Journal of Physiology-Lung Cellular and Molecular Physiology 317, no. 4 (2019): L498—L509. http://dx.doi.org/10.1152/ajplung.00238.2019.

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Muco-obstructive lung diseases (MOLDs), like cystic fibrosis and chronic obstructive pulmonary disease, affect a spectrum of subjects globally. In MOLDs, the airway mucus becomes hyperconcentrated, increasing osmotic and viscoelastic moduli and impairing mucus clearance. MOLD research requires relevant sources of healthy airway mucus for experimental manipulation and analysis. Mucus collected from endotracheal tubes (ETT) may represent such a source with benefits, e.g., in vivo production, over canonical sample types such as sputum or human bronchial epithelial (HBE) mucus. Ionic and biochemic
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15

Jarreau, Pierre-Henri, Bruno Louis, Gilles Dassieu, et al. "Estimation of inspiratory pressure drop in neonatal and pediatric endotracheal tubes." Journal of Applied Physiology 87, no. 1 (1999): 36–46. http://dx.doi.org/10.1152/jappl.1999.87.1.36.

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Endotracheal tubes (ETTs) constitute a resistive extra load for intubated patients. The ETT pressure drop (ΔPETT) is usually described by empirical equations that are specific to one ETT only. Our laboratory previously showed that, in adult ETTs, ΔPETT is given by the Blasius formula (F. Lofaso, B. Louis, L. Brochard, A. Harf, and D. Isabey. Am. Rev. Respir. Dis. 146: 974–979, 1992). Here, we also propose a general formulation for neonatal and pediatric ETTs on the basis of adimensional analysis of the pressure-flow relationship. Pressure and flow were directly measured in seven ETTs (internal
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Bamgbade, Olumuyiwa A., Sikiru A. Adebayo, Ajibola U. Otegbeye, et al. "Acute Lethal Hepato-Bronchial Fistula: Emergency Perioperative Management Using Two Single-Lumen Endotracheal Tubes for Lung Isolation." SVOA Medical Research 2, no. 3 (2024): 56–59. https://doi.org/10.58624/svoamr.2024.02.018.

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Background: Hepato-bronchial fistula (HBF) is a rare complication of hepatic abscess. The usual atypical presentation poses diagnostic and management challenges to clinicians. Case Presentation: This is a case report of acute lethal HBF in an adult who underwent successful surgical management at a hospital in Nigeria. Anaesthetic management was complicated by the lack of appropriate double-lumen endotracheal tubes or bronchial blockers for lung isolation. Therefore, two small cuffed ID=5mm endotracheal tubes (ETT) were used for lung isolation, with a good outcome. Conclusion: This report highl
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Kasper, Carol L., and Steven Deem. "The Self-inflating Bulb to Detect Esophageal Intubation during Emergency Airway Management." Anesthesiology 88, no. 4 (1998): 898–902. http://dx.doi.org/10.1097/00000542-199804000-00008.

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Background The negative-pressure test using a self-inflating bulb (SIB) during emergency intubation was studied to determine its reliability and predictive value in this setting. Methods The endotracheal tube (ETT) position was tested in 300 consecutive patients undergoing in-hospital emergency endotracheal intubation. Immediately after intubation and before ETT cuff inflation, the following protocol was strictly followed: (1) an SIB was compressed, connected to the ETT, and released. A 10-s period was allowed for the bulb to inflate. (2) The ETT cuff was inflated, and the ETT position was con
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Şanal Baş, Sema, Gülay Erdoğan Kayhan, Meryem Onay, and Yeliz Kılıç. "Uncuffed Endotracheal Tube Experience in Pediatric Patients with Laparotomy and Laparoscopic Surgeries." BioMed Research International 2020 (May 9, 2020): 1–5. http://dx.doi.org/10.1155/2020/6325293.

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Aim. The aim of this study is to compare endotracheal tube leak, tube selection, mechanical ventilation, and side effects in the use of uncuffed tubes in both laparoscopic and laparotomy surgeries in pediatric patients. Material and Method. Patients who underwent laparotomy (LT group) or laparoscopic (LS group) surgery between 1 and 60 months. In the selection of uncuffed tubes, it was also planned to start endotracheal intubation with the largest uncuffed tube and to start intubation with a small uncuffed tube if the tube encounters resistance and does not pass. Mechanical parameters, endotra
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Miller, Lucy, Sam Pryke, Ambra Panti, and Miguel Gozalo Marcilla. "Endotracheal tube complication during extubation following surgical repair of a traumatic tracheal laceration." Veterinary Record Case Reports 8, no. 2 (2020): e001087. http://dx.doi.org/10.1136/vetreccr-2020-001087.

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Difficult or impossible tracheal extubation has previously been reported in the veterinary literature as a result of endotracheal tube (ETT) faults or due to their entanglement with oesophagostomy tubes. Inadvertent transfixation of the ETT to the trachea during oral–maxillofacial surgery is a reported cause of extubation complications in the human literature. In this case, an incident of accidental ETT cuff transfixation to the trachea of a dog undergoing surgical repair of a traumatic tracheal laceration is reported. General anaesthesia for tracheal surgery requires special consideration of
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Wani, Tariq M., Ayesha Y. Siddique, Wajahat N. Khan, Saif Rehman, Nguyen K. Tram, and Joseph D. Tobias. "Endotracheal tube cuff position in relationship to the walls of the trachea: A retrospective computed tomography-based analysis." Saudi Journal of Anaesthesia 18, no. 3 (2024): 346–51. http://dx.doi.org/10.4103/sja.sja_36_24.

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Background: The use of cuffed endotracheal tubes (ETTs) has become the standard of care in pediatric practice. The rationale for the use of a cuffed ETT is to minimize pressure around the cricoid while providing an effective airway seal. However, safe care requires that the cuff lie distal to the cricoid ring following endotracheal intubation. The current study demonstrates the capability of computed tomography (CT) imaging in identifying the position of the cuff of the ETT in intubated patients. Methods: The study included patients ranging in age from 1 month to 10 years who underwent neck an
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Prior, Simon, Jarom Heaton, Kris R. Jatana, and Robert G. Rashid. "Parker Flex-Tip and Standard-Tip Endotracheal Tubes: A Comparison During Nasotracheal Intubation." Anesthesia Progress 57, no. 1 (2010): 18–24. http://dx.doi.org/10.2344/0003-3006-57.1.18.

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Abstract The placement of endotracheal tubes in the airway, particularly through the nose, can cause trauma. Their design might be an important etiologic factor, but they have changed little since their introduction. Recently Parker Medical (Bridgewater, Conn ) introduced the Parker Flex-Tip (PFT) tube, suggesting that it causes less trauma. This study aimed to compare the PFT endotracheal tube to a side-beveled, standard-tip endotracheal tube (ETT) for nasotracheal intubation (Figures 1 and 2). Forty consecutive oral surgery patients requiring nasotracheal intubation were randomized to receiv
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Riffat Saeed, Mahrukh Hamza, Tariq Bangash, Amer Latif, Tooba Ammar, and Irfan Ali Kakepotto. "Diagnostic Accuracy Of Ultrasound For Confirmation Of Endotracheal Tube Placement Taking Capnography As A Gold Standard." Proceedings 37, no. 4 (2023): 46–52. http://dx.doi.org/10.47489/szmc.v37i4.436.

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Introduction: Accurate placement of an endotracheal tube (ETT) is critical for patient safety during medical procedures. The research explores the potential of ultrasound technology to provide a reliable alternative for ETT confirmation, offering insights into its diagnostic performance and the implications for enhancing patient care in surgical settings.
 Aims & Objectives: To determine the diagnostic accuracy of ultrasound for the confirmation of endotracheal tube keeping Capnography as a Gold standard.
 Place and Duration of Study: It is a Cross Sectional study and the study w
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Badal, Divakar, Abhijith Vimal Jayarani, Mohammed Ameen Kollaran, Aloke Kumar, and Varsha Singh. "Pseudomonas aeruginosa biofilm formation on endotracheal tubes requires multiple two-component systems." Journal of Medical Microbiology 69, no. 6 (2020): 906–19. http://dx.doi.org/10.1099/jmm.0.001199.

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Introduction. Indwelling medical devices such as endotracheal tubes (ETTs), urinary catheters, vascular access devices, tracheostomies and feeding tubes are often associated with hospital-acquired infections. Bacterial biofilm formed on the ETTs in intubated patients is a significant risk factor associated with ventilator-associated pneumonia. Pseudomonas aeruginosa is one of the four frequently encountered bacteria responsible for causing pneumonia, and the biofilm formation on ETTs. However, understanding of biofilm formation on ETT and interventions to prevent biofilm remains lagging. The a
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Zahid, Dr Mohammad, Dr Ashutosh Jha, Dr Sabir Hasnat, and Dr Prem Anjan. "Comparative Study Of Proseal Laryngeal Mask Airway Versus Cuffed Endotracheal Tube In Patietns Undergoing Laparoscopic Cholecystectomy Under General Anesthesia." IOSR Journal of Dental and Medical Sciences 23, no. 11 (2024): 16–25. https://doi.org/10.9790/0853-2311091625.

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Background: LC is a surgical technique that uses a set of cameras and specially designed instruments to remove the gallbladder through a series of small abdominal incisions. Due to their low invasive nature, laparoscopic surgeries are considered day care procedures. As a result, patients undergoing laparoscopic procedures now get less invasive airway management, such as PLMA, rather than ETT. Nowadays, SADs are frequently employed in the control of airways, falling somewhere among tracheal tubes and face masks both in terms of structural placement and degree of invasiveness. These devices prov
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Young, Emily, Tonya M. Nocera, Matthew Reilly, Joseph D. Tobias, and Ajay D’Mello. "An in vitro technique to measure resistance to compression and kinking of endotracheal tubes." Saudi Journal of Anaesthesia 18, no. 3 (2024): 331–37. http://dx.doi.org/10.4103/sja.sja_15_24.

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Background: During intraoperative care, ventilatory parameters including peak inflating pressure (PIP) and exhaled tidal volumes are continuously monitored to assess changes in respiratory resistance and compliance. Changes in these parameters, such as an increase in PIP or a decrease in the exhaled tidal volume, may indicate various pathologic processes that may require immediate attention to prevent inadequate ventilation resulting in hypoxemia or hypercarbia. A kinked endotracheal tube (ETT) may mimic other pathologic processes including bronchospasm, mainstem intubation, or ventilator malf
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Rabitsch, Werner, Doris Moser, Michelle R. Inzunza, et al. "Airway Management with Endotracheal Tube versus Combitube® during Parabolic Flights." Anesthesiology 105, no. 4 (2006): 696–702. http://dx.doi.org/10.1097/00000542-200610000-00014.

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Background Training of National Aeronautics and Space Administration space shuttle astronauts revealed difficult airway management with endotracheal tubes (ETTs) under microgravity conditions. The authors performed a randomized comparative study of ETT and Combitube (ETC; Tyco Healthcare, Pleasanton, CA). The aim of the study was to evaluate ease, time of insertion, and success rates during normogravity and parabolic flights using mannequins. Methods After normogravity experiments, four flyers performed intubation on a mannequin during the flights. Sixty-two intubation attempts were performed
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Ghoochani Khorasani, Ahmad, Shahin Shadnia, Mohammad Mashayekhian, Mitra Rahimi, and Abbas Aghabiklooei. "Efficacy of Hi-Lo Evac Endotracheal Tube in Prevention of Ventilator-Associated Pneumonia in Mechanically Ventilated Poisoned Patients." Scientifica 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/4901026.

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Background. Ventilator-associated pneumonia (VAP) is the most common health care-associated infection. To prevent this complication, aspiration of subglottic secretions using Hi-Lo Evac endotracheal tube (Evac ETT) is a recommended intervention. However, there are some reports on Evac ETT dysfunction. We aimed to compare the incidence of VAP (per ventilated patients) in severely ill poisoned patients who were intubated using Evac ETT versus conventional endotracheal tubes (C-ETT) in our toxicology ICU.Materials and Methods. In this clinical randomized trial, 91 eligible patients with an expect
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Saxena, Dipti, Jyoti Raghuwanshi, Atul Dixit, and Subodh Chaturvedi. "Endotracheal tube cuff pressure during laparoscopic bariatric surgery: highs and lows." Anesthesia and Pain Medicine 17, no. 1 (2022): 98–103. http://dx.doi.org/10.17085/apm.21044.

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Background: Gastric calibration tubes (GCTs) are a unique component of bariatric surgery. This study aimed to assess changes in the endotracheal tube (ETT) cuff pressure during laparoscopic bariatric surgery.Methods: This was a prospective observational study consisting of 124 American Society of Anesthesiologists class I–III morbidly obese patients (body mass index > 40 kg/m2) undergoing elective laparoscopic bariatric surgery under general anesthesia. The baseline ETT cuff pressure was 28 cmH2O. Cuff pressure, peak airway pressure, and hemodynamic changes were observed during various step
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Sakhuja, Pankaj, Michael Finelli, Judy Hawes, and Hilary Whyte. "Is It Time to Review Guidelines for ETT Positioning in the NICU? SCEPTIC—Survey of Challenges Encountered in Placement of Endotracheal Tubes in Canadian NICUs." International Journal of Pediatrics 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/7283179.

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Objectives. To examine current opinions and practices regarding endotracheal tube placement across several Canadian Neonatal Intensive Care Units.Design. Clinical directors from Canadian Neonatal Network affiliated NICUs and Neonatal-Perinatal Programs across Canada were invited via email to participate in and disseminate the online survey to staff neonatologists, neonatal fellows, respiratory therapists, and nurse practitioners.Result. There is wide variability in the beliefs and practices related to ETT placement. The majority use “weight +6” formula and “aim to black line” on ETT at vocal c
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Flintoff, Marcus. "A is for airway: intubation guide for common species (part 1)." Veterinary Nurse 16, no. 1 (2025): 36–38. https://doi.org/10.12968/vetn.2024.0026i.

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Endotracheal intubation is a vital aspect of anaesthetic management in veterinary patients. It enables the delivery of volatile inhalants with 100% oxygen, reduces hypoxia risk, prevents environmental pollution and safeguards the airway against regurgitation and aspiration. Successful intubation requires knowledge of patient anatomy, appropriate endotracheal tube (ETT) and species-specific techniques. Proper measurement of ETTs, especially in smaller species, prevents complications such as bronchial intubation, which can cause uneven ventilation and hypoxia. This article reviews the types of E
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Rosenblatt, Joel, Ruth Reitzel, Ying Jiang, Ray Hachem, and Issam Raad. "Insights on the Role of Antimicrobial Cuffed Endotracheal Tubes in Preventing Transtracheal Transmission of VAP Pathogens from anIn VitroModel of Microaspiration and Microbial Proliferation." BioMed Research International 2014 (2014): 1–11. http://dx.doi.org/10.1155/2014/120468.

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We developed anin vitromodel to evaluate the effect of different cuffed endotracheal tubes (ETTs) on transtracheal transmission of ventilator-associated pneumonia (VAP) pathogens along external surfaces of ETTs. The model independently assessed the relative contributions of microbial proliferation to the distal tip and microaspiration of contaminated secretions past the cuff by testing in three modes: microaspiration only, microbial proliferation only, and simultaneous microaspiration and microbial proliferation. We evaluated transmission of methicillin resistantStaphylococcus aureus(MRSA) orP
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Villafane, Maria Cristina, Gilda Cinnella, Frederic Lofaso, et al. "Gradual Reduction of Endotracheal Tube Diameter during Mechanical Ventilation via Different Humidification Devices." Anesthesiology 85, no. 6 (1996): 1341–49. http://dx.doi.org/10.1097/00000542-199612000-00015.

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Background Limited data suggest that increased resistance to flow within endotracheal tubes (ETT) may occur in patients whose lungs are mechanically ventilated for more than 48 h, especially when airway humidification is inadequate. This could lead to sudden ETT obstruction or induce excessive loading during spontaneous breathing. Methods Twenty-three such patients were randomly assigned to three types of airway humidifier based on three different working principles: a Fisher Paykell hot water system (n = 7), a Pall BB2215 heat and moisture exchanger (HME) hydrophobic filter (n = 8), and a Dar
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33

Park, Seyeon, Jisoo Ahn, Sung Uk Yoon, et al. "Prediction of endotracheal tube size using a printed three-dimensional airway model in pediatric patients with congenital heart disease: a prospective, single-center, single-group study." Korean Journal of Anesthesiology 74, no. 4 (2021): 333–41. http://dx.doi.org/10.4097/kja.21114.

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Background: To determine the correct size of endotracheal tubes (ETTs) for endotracheal intubation of pediatric patients, new methods have been investigated. Although the three-dimensional (3D) printing technology has been successful in the field of surgery, there are not many studies in the field of anesthesia. The purpose of this study was to evaluate the accuracy of a 3D airway model for prediction of the correct ETT size, and compare the results with a conventional age-based formula in pediatric patients.Methods: Thirty-five pediatric patients under six years of age who were scheduled for
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Chen, Ruo S., Laurel O’Connor, Matthew R. Rebesco, Kara L. LaBarge, Edgar J. Remotti, and Joseph C. Tennyson. "Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department." Prehospital and Disaster Medicine 36, no. 3 (2021): 283–86. http://dx.doi.org/10.1017/s1049023x21000297.

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AbstractIntroduction:Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the aver
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Sastamidhyani, Ni Putu Ayu J., Ni Luh Widani, and Agustinus Bandur. "Patient Discomfort Experience During ETT Insertion in Intensive Care Unit Husada Hospital Jakarta, Indonesia." Babali Nursing Research 3, no. 3 (2022): 315–24. http://dx.doi.org/10.37363/bnr.2022.33200.

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Introduction: Organ dysfunction may lead to critical disease. The critical disease has put many patients to be monitored intensively during medical treatment to restore their body function. Most ventilator usage is to support recovery from respiratory system problems. A ventilator is connected to an Endo Tracheal Tube inserted into the patient’s mouth. This study aims to explore in depth the meaning of patient experience dealing with endotracheal tube insertion during hospitalization in intensive care unit.
 Methods: This study used a qualitative research design with an interpretative phe
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36

Ling, Xiaomei, Xuemeng Chen, Gaowang Liu, et al. "Safety and Efficacy of a Novel Intubating Laryngeal Mask during the recovery period following Supratentorial Tumour Surgery." Journal of International Medical Research 49, no. 3 (2021): 030006052199976. http://dx.doi.org/10.1177/0300060521999768.

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Objective To assess safety and efficacy of a novel intubation laryngeal mask airway (ILMA) during the recovery period following supratentorial tumour surgery. Methods Patients who underwent supratentorial tumour surgery at our centre from January 2012 to December 2016 were eligible for this prospective randomised, parallel group study. We developed a novel ILMA using closely fitting laryngeal masks (No. 4/5) with 7.0/7.5 mm endotracheal tubes (ETT) plus screw fixators and anti-pollution sleeves. Results In total, 100 patients were intubated with the novel ILMA and 100 the ETT. There were no di
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Janani, SR, Dheeraj Masapu, DN Dhananjay, Satish Rudrappa, Ramachandran Govindasamy, and T. Jagadish. "Comparison between microcuff and wire-reinforced endotracheal tubes on postoperative complications in anterior cervical discectomy and fusion: A randomised study." Indian Journal of Anaesthesia 69, no. 7 (2025): 675–80. https://doi.org/10.4103/ija.ija_1046_24.

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Background and Aims: This randomised study investigated whether microcuff endotracheal tubes (ETT) reduce postoperative complications compared to wire-reinforced ETT in patients undergoing anterior cervical discectomy and fusion (ACDF). Methods: In total, 120 patients were randomly assigned to receive either a microcuff ETT (Group M) or a wire-reinforced ETT (Group W) during surgery. Intraoperative cuff pressure changes due to retractor use were noted. Postoperative complications such as vocal cord palsy and airway oedema were observed at extubation, and hoarseness, sore throat, dysphagia, and
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Minoura, Hironori, Takashi Ichino, and Masatomo Kitamura. "Respiratory Complications Between Cuffed and Uncuffed Endotracheal Tubes in Pediatric Respiratory Management After Palatoplasty: Single-Center Retrospective Cohort Study." Critical Care Explorations 4, no. 12 (2022): e0817. http://dx.doi.org/10.1097/cce.0000000000000817.

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OBJECTIVES: We aimed to examine the associations between use of cuffed or uncuffed endotracheal tubes (ETTs) and complications during and after short-term intubation of post-palatoplasty patients without intrinsic lung disease. DESIGN: Retrospective cohort study. SETTING: Operating room and PICU. PATIENTS: Children without intrinsic lung disease who had undergone palatoplasty at a single institution. Inclusion criteria: intubation using ETTs with an internal diameter of 3.5 mm and postoperative management in the PICU. Exclusion criteria: 1) patients for whom ETTs with internal diameters other
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Chumpathong, Saowapark, Petcharat Sukavanicharat, Wassana Butmangkun, et al. "Effectiveness of endotracheal-tube size by age-based formula for Thai pediatric cardiac patients: a retrospective study." Asian Biomedicine 4, no. 5 (2010): 765–71. http://dx.doi.org/10.2478/abm-2010-0099.

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Abstract Background: Pediatric patients with congenital heart diseases may have pathological airway abnormality and delayed development. To predict the appropriate size of endotracheal tube (ETT), a formula between diameter and age has been widely used for Western normal children. However, it is unclear whether this age-based (AB) formula is applicable to Thai pediatric cardiac patients. Objective: Evaluate the effectiveness of uncuffed ETT size by AB formula for pediatric cardiac patients. Methods: A retrospective study was conducted using 320 cases of non-cardiac and cardiac patients aged 2-
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40

Black, Angela P., and James D. Sidman. "S254 – Bone Conduction Noise Exposure via Ventilators in the NICU." Otolaryngology–Head and Neck Surgery 139, no. 2_suppl (2008): P160. http://dx.doi.org/10.1016/j.otohns.2008.05.430.

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Objectives To demonstrate that neonatal ventilators produce high noise levels through bone conduction (BC) via endotracheal tubes, as well as air conduction (AC) from ambient noise. Methods A sound level meter was used to measure the noise levels 4 feet from the ventilator and in direct contact at the end of a balloon attached to the ETT to simulate the noise presented to the infant. 3 commonly used neonatal ventilators (Sensormedics 3100A, VIP Bird and Bunnell Jet) were examined. Results Noise levels were significantly higher (6 – 14 dB) at the end of the ETT than 4 ft from the ventilator for
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Yuan, Kuo-Ching, Lung-Wen Tsai, Kevin S. Lai, Sing-Teck Teng, Yu-Sheng Lo, and Syu-Jyun Peng. "Using Transfer Learning Method to Develop an Artificial Intelligence Assisted Triaging for Endotracheal Tube Position on Chest X-ray." Diagnostics 11, no. 10 (2021): 1844. http://dx.doi.org/10.3390/diagnostics11101844.

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Endotracheal tubes (ETTs) provide a vital connection between the ventilator and patient; however, improper placement can hinder ventilation efficiency or injure the patient. Chest X-ray (CXR) is the most common approach to confirming ETT placement; however, technicians require considerable expertise in the interpretation of CXRs, and formal reports are often delayed. In this study, we developed an artificial intelligence-based triage system to enable the automated assessment of ETT placement in CXRs. Three intensivists performed a review of 4293 CXRs obtained from 2568 ICU patients. The CXRs w
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42

Buck, Melissa, Michael Antunes, Brewster Kingham, Shawn W. Polson, and Stephen C. Eppes. "590. Reduction of Endotracheal Colonization by Gram-Negative Bacilli in a Neonatal Intensive Care Unit Through Use of a Novel Drain Cover." Open Forum Infectious Diseases 6, Supplement_2 (2019): S279. http://dx.doi.org/10.1093/ofid/ofz360.659.

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Abstract Background Splash and aerosolization from sink drains are a source of contamination, particularly by Gram-negative bacilli (GNB), in healthcare facilities. Neonatal Intensive Care Unit (NICU) outbreaks of infection due to GNB have been attributed to NICU sinks. Recent studies found that a dome-shaped drain cover placed in sinks in an adult ICU prevented dispersal of sink drain bacteria to the environment and hands of healthcare providers. Our NICU routinely performs weekly surveillance cultures of all endotracheal tubes (ETT) and has previously reported a correlation of ETT colonizing
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Codru, Ioana Roxana, Bogdan Ioan Vintilă, Alina Simona Bereanu, Mihai Sava, Livia Mirela Popa, and Victoria Birlutiu. "Antimicrobial Resistance Patterns and Biofilm Analysis via Sonication in Intensive Care Unit Patients at a County Emergency Hospital in Romania." Pharmaceuticals 18, no. 2 (2025): 161. https://doi.org/10.3390/ph18020161.

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Background/Objectives: Ventilator-associated pneumonia (VAP) remains a critical challenge in ICU settings, often driven by the biofilm-mediated bacterial colonization of endotracheal tubes (ETTs). This study investigates antimicrobial resistance patterns and biofilm dynamics in ICU patients, focusing on microbial colonization and resistance trends in tracheal aspirates and endotracheal tube biofilms at a county emergency hospital in Romania. Methods: We conducted a longitudinal analysis of ICU patients requiring mechanical ventilation for more than 48 h. Tracheal aspirates and ETT biofilms wer
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Vellapally, Thomas T., Deepa Baskaran, and Michelle Meril Reginald. "Correlation of upper incisor–manubriosternal joint length with upper incisor–carinal length to predict airway length in the pediatric population: An observational study." Asian Journal of Medical Sciences 16, no. 6 (2025): 116–21. https://doi.org/10.71152/ajms.v16i6.4510.

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Background: Short and variable length of the trachea precludes accurate placement of endotracheal tubes (ETTs) in the pediatric population. The incidence of malposition of the ETT in the pediatric population was reported to be 30–50% warranting repositioning. The manubriosternal joint (MSJ) and the carina lie in the same horizontal plane. This can be utilized as a guide during endotracheal intubation in children. Aims and Objectives: To evaluate the correlation between the incisor-MSJ (IMSL) length measured in extension and the incisor–carinal length (ICL) and to predict the airway length in t
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Wong, Chui King, Glen Chiang Hong Tan, and Mohd Johar Jaafar. "MASSIVE LIFE-THREATENING SUBCUTANEOUS EMPHYSEMA: A MANIFESTATION OF TRACHEOBRONCHIAL INJURY." Journal of Health and Translational Medicine 24, no. 2 (2021): 72–75. http://dx.doi.org/10.22452/jummec.vol24no2.10.

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Subcutaneous emphysema, a known complication of tracheobronchial injury (TBI), is usually a self-limiting condition, but occasionally, a massive one can become life-threatening. We present a patient with TBI who developed massive subcutaneous emphysema with bilateral pneumothorax causing hemodynamic instability. Upon arrival to the hospital, the patient required emergent intubation for impending respiratory collapse. Bilateral thoracostomy tubes were inserted, resulting in hemodynamic improvement. Emergent CT thorax showed a tracheal-oesophageal injury just distal to the cuff of the endotrache
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Klonner, Moriz Ettore, Giorgio Mattaliano, Vincenzo Casoria, Claus Vogl, and Christina Braun. "Disposable Airway Pressure Manometers for Endotracheal Tube Cuff Inflation." Animals 13, no. 3 (2023): 475. http://dx.doi.org/10.3390/ani13030475.

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This study aimed to assess the performance, accuracy, precision and repeatability of two single-use airway pressure manometers as a cost-effective alternative for inflation of endotracheal tubes with high-volume, low-pressure cuffs. The manometers were tested in a bench top model against a U-tube manometer. Eighteen units of each device were tested. Three consecutive measurements were performed at pressures of 20, 25 and 30 cmH2O each. The mean ± SD of the recorded pressures and maximum deviation from the target pressures were calculated for each device and each target pressure. For device A,
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Zhang, Yan-Nan, Hai-Yan Shi, Wang-Qin Shen, et al. "Effect of varying cuff sizes with identical inner diameter on endotracheal intubation in critically ill adults: A sealed tracheal controlled trial." Medicine 103, no. 24 (2024): e38326. http://dx.doi.org/10.1097/md.0000000000038326.

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Background: The present study aims to determine the impact of different cuff diameters on the cuff pressure of endotracheal tubes (ETTs) when the trachea is adequately sealed. Methods: In the present single-center clinical trial, adult patients who underwent cardiothoracic surgery were assigned to use ETTs from 2 brands (GME and GZW). The primary endpoint comprised of the following: cuff diameter, inner diameter of the ETT, manufacturer, and the number of subjects with tracheal leakage when the cuff pressure was 30 cm H2O. Results: A total of 298 patients were assigned into 2 groups, based on
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Dr., Ali Shawqi Saadoon, Ali Mohammed Dnan Dr., and Maysoon Ali Abdulkareem Dr. "Endotracheal Tube Associated Microbiome in the Intensive Care Unit." Sarcouncil journal of Medical sciences 3, no. 3 (2024): 16–22. https://doi.org/10.5281/zenodo.10805982.

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<strong>Background</strong>: Exploration of the microbiome within the respiratory tract predominantly centers on the diversity of microorganisms in the airways and lungs. However, there remains a lack of clarity regarding the potential impact of intubation and prolonged stays in intensive care units (ICU) on these microbial communities. <strong>Aim of the study:</strong> The present investigation sought to examine and characterize the microbiome of endotracheal tubes (ETT), along with assessing their susceptibility and resistance to antimicrobial agents. <strong>Patients and methods:</strong>
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Calkins, Thomas R., Ken Miller, and Mark I. Langdorf. "Success and Complication Rates with Prehospital Placement of an Esophageal-Tracheal Combitube as a Rescue Airway." Prehospital and Disaster Medicine 21, no. 2 (2006): 97–100. http://dx.doi.org/10.1017/s1049023x00003423.

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AbstractIntroduction:Previous studies have proven the success of the EsophagealTracheal Combitube (ETC) as a primary airway, but not as a rescue airway.Objective:The object of this study was to observe success and complication rates of paramedic placement of an ETC as a rescue airway, and to compare success rates with endotracheal tube (ETT) intubation. The primary outcome indicator was placement with successful ventilation. Complication rates, esophageal placement, and return of spontaneous circulation (ROSC) were secondary measures.Methods:A retrospective review of the records of patients wh
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Nienaber, Thomas, Sarah Perez, Krista Stephenson, et al. "312 Developing a Digitally Integrated Endotracheal Tube for Neonates to Improve Safety and Respiratory Function." Journal of Clinical and Translational Science 6, s1 (2022): 55. http://dx.doi.org/10.1017/cts.2022.172.

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OBJECTIVES/GOALS: Neonatal endotracheal tubes (ETTs) are usually uncuffed to avoid subglottic stenosis and other complications, but cuffed ETTs allow better ventilation. Our goal was to detect and control pressure in the cuff below the limit of occluding venous flow to minimize the risk of subglottic stenosis. METHODS/STUDY POPULATION: We designed a pressure sensor to fit on a 2.5 ETT for prototype testing in 8 age adult female rabbits. Eight uncuffed age- and sex- matched rabbits served as control. Study duration was 2 hours during which pressure in the cuff was limited by novel sensor (inter
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