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Use of cuffed endotracheal tubes in infants less than 5 kilograms: A retrospective cohort study
Zachary C Williams1, Stephani S Kim2, Aymen Naguib2
1The Ohio State University College of Medicine, Columbus, OH USA.
Insights
Cuffed endotracheal tubes (ETTs) are safe and effective for infants weighing 2-5 kg. Use of cuffed ETTs in this population reduced the need for repeat intubations and ETT size changes without increasing airway complications.
Area of Science:
- Pediatric Anesthesiology
- Airway Management
- Neonatal Critical Care
Background:
- Cuffed endotracheal tubes (ETTs) are increasingly used in pediatric patients.
- Limited data exists on cuffed ETT use in infants weighing less than 5 kg.
- This study addresses the evidence gap for cuffed ETTs in this specific infant weight group.
Purpose of the Study:
- To retrospectively evaluate the perioperative use of cuffed ETTs in infants weighing 2-5 kg.
- To assess the safety and efficacy of cuffed ETTs in this vulnerable patient population.
- To compare outcomes between cuffed and uncuffed ETTs in infants.
Main Methods:
- Retrospective study conducted at a tertiary care children's hospital over 3 years.
- Data collected from electronic medical records on anesthetic care, airway management, and postoperative course.
- Patients categorized into weight groups: 2 to <3 kg and 3 to 5 kg.
Main Results:
- A total of 1162 infants were included; 1086 received cuffed ETTs and 76 received uncuffed ETTs.
- Cuffed ETTs significantly decreased the need for multiple laryngoscopies and ETT size changes in both weight groups.
- No increase in postoperative airway complications, such as stridor, was observed with cuffed ETTs.
Conclusions:
- Cuffed ETTs are effective and safe for infants weighing 2-5 kg.
- These findings support the expanded use of cuffed ETTs in neonates and infants.
- Provides valuable data on cuffed ETT efficacy in a low-weight pediatric population.
Background:
Improved understanding of airway anatomy and refinement of equipment have led to the increased use of cuffed endotracheal tubes (ETTs) in infants and children. Despite expanded evidence on the potential advantages of cuffed ETTs in pediatric patients, there remains limited data on their use in infants less than 5 kilograms (kg). The current study retrospectively evaluates the perioperative use of cuffed ETTs in infants weighing 2-5 kg.
Methods:
This is a retrospective study from a tertiary care children's hospital involving a 3-year period. Data regarding anesthetic care, airway management, and postoperative course were retrospectively retrieved from the electronic medical record.
Results:
The study cohort included 1162 patients, 1086 of whom had their tracheas intubated with a cuffed ETT and 76 with an uncuffed ETT. Patients were divided into two groups for analysis: 2 to <3 kg and 3 to 5 kg. In both weight groups, cuffed ETTs resulted in a decreased need for more than one laryngoscopy and a change in ETT size with no increase in postoperative airway effects including stridor.
Conclusions:
These data provide additional information regarding the efficacy and safety of cuffed ETTs in neonates and infants.
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