Uncuffed Endotracheal Tube Experience in Pediatric Patients with Laparotomy and Laparoscopic Surgeries

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, endotracheal tube size, tube changes, and side effects are recorded.

A total of 102 patients, 38 females and 64 males, with a mean age of 10.9 ± 8.1 months, body weight 7.1 ± 3.7 kg, and height 67 ± 15 cm, were included. 54 patients underwent laparoscopic surgery, and 48 patients underwent laparotomy. Tube exchange was performed in a total of 18 patients. In patients who underwent tube exchange, 11 patients were intubated with a smaller ETT number and others endotracheal intubation; when the MV parameters were TVe < 8 ml/kg and ETT leak > 20%, a larger uncuffed tube was used due to PIP 30 cmH₂O pressure. Patients with aspiration were not found in the LT and LS groups. There was no difference in the intergroup evaluation for postoperative side effects such as cough, laryngospasm, stridor, and aspiration.

There was no significant difference between the groups in terms of tube changes and side effects. So that we can start with the largest possible uncuffed tube to decrease ETT leak, both laparotomy and laparoscopic operations in children can be achieved with safe mechanical ventilation and target tidal volume.