Comparison of Flow Resistance Characteristics and Placement of Two Endotracheal Tubes

BACKGROUND: In a traditional endotracheal tube (ETT), there is a linear outward pull through its attachment to the ventilator tubing that leads to risk of accidental dislodgement. This study was conducted to assess the ETT flow characteristics and to evaluate providers’ intubation experience using two ETT’s in a simulated setting.

METHODS: Respiratory pressure–volume dynamics for the 2 ETTs were studied in a simulation laboratory by using 3 different flow settings and 2 different test lungs. The time taken for successful intubation on a mannikin was compared by direct observation of 33 separate intubation attempts by 11 different providers. Comfort with intubation by using both tubes was assessed with a Likert scale– based survey. The potential increase in physical and cognitive work load of nurses and respiratory therapists was assessed by the NASA task load index.

RESULTS: There were slightly lower average tidal volumes delivered with SecureTube compared with the standard tube at different peak inspiratory pressures. Similarly, the same tidal volume delivered with a different flow and bag compliance required slightly higher peak inspiratory pressure compared with the standard ETT. Among providers, there was no difference in the average time to intubate when using either tube. All survey respondents (N = 11) rated intubation attempts with the SecureTube to be very easy compared with the standard tube. The NASA task load index (N = 26) showed very low task loads on all the tasks.

CONCLUSIONS: There was minimal impact on flow resistance on pressure or volume with the SecureTube compared with the standard tube. Most providers felt comfortable intubating with the SecureTube and took a comparable amount of time to intubate in a simulated setting. We observed low task load scores for securement, maintenance, and manipulation per nurses and respiratory therapists.