Postal survey of cuffed or uncuffed tracheal tubes used for paediatric tracheal intubation

Area of Science:

• Pediatric Anesthesiology
• Airway Management
• Medical Device Usage

Background:

• Cuffed tracheal tubes (CTTs) offer potential benefits in pediatric airway management.
• However, their routine use and proper management, particularly cuff inflation, remain subjects of practice variation.

Purpose of the Study:

• To investigate the current practices and decision-making criteria for using cuffed or uncuffed tracheal tubes in pediatric and infant intubation.
• To understand the methods employed by pediatric anesthesiologists for inflating the cuffs of CTTs.

Main Methods:

• A postal survey was distributed to 200 pediatric anesthesiologists.
• A response rate of 65% (130 participants) was achieved, providing data on CTT usage and cuff inflation strategies.

Main Results:

• Only 25% of respondents routinely used CTTs for over 80% of pediatric patients; 37% used them in less than 20% of cases.
• Primary criteria for cuff inflation included leak presence (32%), surgery type with leak (24%), and patient age/surgery/leak (18%).
• Cuff inflation was based on leak detection in 18% and pressure manometer in 15% of cases.

Conclusions:

• Routine use of CTTs in pediatric intubation is infrequent among surveyed anesthesiologists.
• Cuff inflation practices often lack reliance on pressure monitoring devices, contrary to suggested best practices for CTT management.