OBJECTIVE: To report our experience with cuffed endotracheal tubes (ETT) in a large cohort of critically ill children. Study design We prospectively collected data over a 1-year period concerning long-term intubation on 860 critically ill children admitted to our intensive care unit. Tube sizes were dictated by the modified Cole formula for uncuffed ETT (age [y]/4+4 mm ID) and chosen one-half size less for cuffed ETT. Cuff pressure was regularly monitored to maintain a small leak at peak inspiratory pressure. The choice of ETT was made by the physician responsible for the initial airway management. RESULTS: There were 597 patients in the first 5 years of life, with 210 having cuffed ETT. There were no significant differences in the use of racemic epinephrine for postextubation subglottic edema, the rate of successful extubation or the need for tracheotomy between those with cuffed and uncuffed ETT in any age group. CONCLUSIONS: Our data suggest that the traditional teaching in pediatric anesthesia and intensive care, including current pediatric life support recommendations, need to be reviewed for children to benefit from the advantages of modern low-pressure cuffed ETT during critical illnesses.
OBJECTIVE: To report our experience with cuffed endotracheal tubes (ETT) in a large cohort of critically ill children. Study design We prospectively collected data over a 1-year period concerning long-term intubation on 860 critically ill children admitted to our intensive care unit. Tube sizes were dictated by the modified Cole formula for uncuffed ETT (age [y]/4+4 mm ID) and chosen one-half size less for cuffed ETT. Cuff pressure was regularly monitored to maintain a small leak at peak inspiratory pressure. The choice of ETT was made by the physician responsible for the initial airway management. RESULTS: There were 597 patients in the first 5 years of life, with 210 having cuffed ETT. There were no significant differences in the use of racemic epinephrine for postextubation subglottic edema, the rate of successful extubation or the need for tracheotomy between those with cuffed and uncuffed ETT in any age group. CONCLUSIONS: Our data suggest that the traditional teaching in pediatric anesthesia and intensive care, including current pediatric life support recommendations, need to be reviewed for children to benefit from the advantages of modern low-pressure cuffed ETT during critical illnesses.
Authors: Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman Journal: Circulation Date: 2010-10-19 Impact factor: 29.690
Authors: Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman Journal: Pediatrics Date: 2010-10-18 Impact factor: 7.124
Authors: Alan S Graham; Girish Chandrashekharaiah; Agop Citak; Randall C Wetzel; Christopher J L Newth Journal: Intensive Care Med Date: 2006-11-17 Impact factor: 17.440
Authors: Robinder G Khemani; Justin Hotz; Rica Morzov; Rutger Flink; Asavari Kamerkar; Patrick A Ross; Christopher J L Newth Journal: Am J Respir Crit Care Med Date: 2016-01-15 Impact factor: 21.405
Authors: Punkaj Gupta; Joseph D Tobias; Sunali Goyal; Jacob E Kuperstock; Sana F Hashmi; Jennifer Shin; Christopher J Hartnick; Natan Noviski Journal: Saudi J Anaesth Date: 2010-09