Larger Endotracheal Tubes Are Associated With an Increased Risk of Post-Extubation Diet Modifications.

Area of Science:

• Critical Care Medicine
• Otolaryngology
• Speech and Language Pathology

Background:

• Current guidelines for endotracheal tube (ETT) sizing lack widespread adoption.
• The association between larger ETTs and upper aerodigestive tract injury is suspected but not definitively established.

Purpose of the Study:

• To investigate the relationship between endotracheal tube (ETT) size and post-extubation diet recommendations.
• To assess the risk of upper aerodigestive injury associated with ETT sizing.

Main Methods:

• Retrospective analysis of patients undergoing endotracheal intubation.
• Utilized ICD-10 PCS codes for patient identification.
• Employed univariable and multivariable regression analyses to explore the ETT size-diet recommendation relationship.

Main Results:

• 1181 patients were included in the study.
• A height-based nomogram classified ETTs as smaller, expected, or larger than anticipated.
• Each 1.0 unit increase in ETT size was associated with doubled odds of requiring diet modification (OR: 2.05, 95% CI: 1.49-2.85) after adjusting for confounding factors.

Conclusions:

• Larger endotracheal tube sizes may correlate with an increased risk of upper aerodigestive injury.
• Findings suggest a need for future studies to validate these results and develop evidence-based ETT sizing guidelines.