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Which is the safest endotracheal tube for use with the CO2 laser? A comparative study
1Department of Anesthesiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
Study Objective:
To compare the efficacy of special endotracheal tubes manufactured for carbon dioxide (CO2) laser surgery with foil-wrapped and plain red rubber (RR) endotracheal tubes.
Setting:
Research laboratory of a metropolitan, university-affiliated medical center.
Design And Interventions:
Six types of endotracheal tubes were studied. Each had 5 L/min of oxygen passing through it and was exposed to 69 watts of continuous CO2 laser radiation for 1 minute or until combustion occurred.
Measurements And Main Results:
The plain RR endotracheal tube burned within 15 seconds of laser impact. Aluminum foil-wrapped and copper foil-wrapped RR endotracheal tubes were not affected by the CO2 laser. The shaft of a specially manufactured stainless steel endotracheal tube was not affected by 1 minute of CO2 laser exposure. The shafts of two special endotracheal tubes made of silicone and metal burned vigorously under laser fire.
Conclusion:
Copper foil-wrapped RR tubes, aluminum foil-wrapped RR tubes, or stainless steel tubes are recommended for laser airway surgery.