The use of cuffed versus uncuffed endotracheal tubes in pediatric intensive care
Section snippets
Methods
Data were gathered over a 12-month period on all intubated medical and surgical patients admitted to a 20-bed multidisciplinary intensive care unit and a 15-bed cardiothoracic intensive care unit. Fifty-five percent of the patients admitted during this period were intubated, and there were 860 episodes of patient intubation. Patients' ages ranged from 1 day to 30 years. There were 377 cardiac cases and 483 noncardiac patients. Data collected included the patient's age, weight, and diagnosis.
Results
There were 860 episodes of intubation and extubation (Table I). The overwhelming majority of ETT were manufactured by Mallinckrodt (Nellcor, Pleasanton, Calif). Overall, extubation was successful on the first attempt in 92.7% of patients (ie, failed extubations were 7.3%, or 1.3 per 100 days of mechanical ventilation). There were 597 patients younger than 5 years of age, with 210 having a cuffed ETT and 387 having an uncuffed ETT (see Table II). Overall, patients with cuffed ETT spent
Discussion
Our study demonstrates that cuffed ETT can be safely used for prolonged periods of time without causing short- or long-term side-effects. Our data showed that the practice of using cuffed ETT on appropriate occasions in the pediatric patient population has not declined over the intervening years since our first study9 and has become the standard of care in our intensive care units and in others.12 Indeed, judging by the PRISM score (a pediatric risk of death index scored at the end of the first
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