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The impact of head position on the cuff and tube tip position of preformed oral tracheal tubes in young children

Jordi Ritz, E. M. and Von Ungern Sternberg, B. S. and Keller, K. and Frei, F. J. and Erb, T. O.. (2008) The impact of head position on the cuff and tube tip position of preformed oral tracheal tubes in young children. Anaesthesia, Vol. 63. pp. 604-609.

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Official URL: http://edoc.unibas.ch/dok/A4989283

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Abstract

Head and neck movements affect both the length of the trachea and the position of tracheal tubes. This is of relevance when using cuffed tubes because changes in the position of the tube tip may not be equal to changes in the position of the cuff. The aim of the study was to assess the impact of head and neck movement on the position of the tube tip and the cuff of newly designed, oral preformed tracheal tubes in children. The tracheas of 128 children aged 1-8 years were intubated with preformed oral tubes. The distances 'carina-to-tracheal tube tip' and 'vocal cords-to-tube tip' were measured endoscopically. These measurements were performed with the head and neck in a functional neutral position (110 degrees ), during neck flexion (80 degrees ) and neck extension (130 degrees ). Tracheal length was dependent on head and neck position: neck extension elongated the trachea (p > 0.0001), and neck flexion shortened the trachea (p > 0.0001). Neck flexion moved the tube inward and resulted in endobronchial displacement in two patients. Neck extension moved the tube outwards. While no cuff was positioned between the vocal cords, cuff movement to the cricoid area occurred frequently. Complex interactions during head and neck movement along with the fixed insertion depth of preformed tubes often cause inadvertent malpositioning of the tube tip and cuff. Further changes to tube and cuff lengths might improve the safety of oral preformed tubes in children.
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Anästhesiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Anästhesiologie
UniBasel Contributors:Frei, Franz Josef and Erb, Thomas O.
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Pulman
ISSN:0003-2409
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:08 Nov 2012 16:23
Deposited On:08 Nov 2012 16:20

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