Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children.
Détails
ID Serval
serval:BIB_306D53AA4458
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children.
Périodique
British journal of anaesthesia
Collaborateur⸱rice⸱s
European Paediatric Endotracheal Intubation Study Group
Contributeur⸱rice⸱s
Bernath M., Best C., Bew S., Bihlmayer J., Bloch M., Boels V., Bolton P., Boos K., Brooks P., Brown J., Crass D., Csomor D., Dolci M., Engelhardt T., Eschertzhuber S., Forst H., Frank B., Frotzler A., Gabriel O., Gajdosiva L., Galton S., Gerheuser F., Giest J., Greif R., Grochova M., Habre W., Hadrawa M., Hartmann B., Heindl W., Henze G., Hilfiker O., Hivey S., Hoehne C., Hollnberger H., Hüttl T., Kalnasova B., Kirwan T., Komanova B., Korcek J., Krohn S., Kulkarni M., Lonnqvist P.A., Machotta A., Meakin G., Mixa V., Morton N., Nicolai T., Oberhauser M., Pellegrini M., Pirotte T., Podhoransky B., Rapp H.J., Rolfs M., Roth W., Salgo B., Schepperle H., Schimpf J., Schmitz A., Sollmann V., Seiler S., Strauss J., Stucki F., Thil E., Veyckemans F., Wichert L., Willker A., Wilson G.
ISSN
1471-6771 (Electronic)
ISSN-L
0007-0912
Statut éditorial
Publié
Date de publication
12/2009
Peer-reviewed
Oui
Volume
103
Numéro
6
Pages
867-873
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
The use of cuffed tracheal tubes (TTs) in small children is still controversial. The aim of this study was to compare post-extubation morbidity and TT exchange rates when using cuffed vs uncuffed tubes in small children.
Patients aged from birth to 5 yr requiring general anaesthesia with TT intubation were included in 24 European paediatric anaesthesia centres. Patients were prospectively randomized into a cuffed TT group (Microcuff PET) and an uncuffed TT group (Mallinckrodt, Portex, Rüsch, Sheridan). Endpoints were incidence of post-extubation stridor and the number of TT exchanges to find an appropriate-sized tube. For cuffed TTs, minimal cuff pressure required to seal the airway was noted; maximal cuff pressure was limited at 20 cm H(2)O with a pressure release valve. Data are mean (SD).
A total of 2246 children were studied (1119/1127 cuffed/uncuffed). The age was 1.93 (1.48) yr in the cuffed and 1.87 (1.45) yr in the uncuffed groups. Post-extubation stridor was noted in 4.4% of patients with cuffed and in 4.7% with uncuffed TTs (P=0.543). TT exchange rate was 2.1% in the cuffed and 30.8% in the uncuffed groups (P<0.0001). Minimal cuff pressure required to seal the trachea was 10.6 (4.3) cm H(2)O.
The use of cuffed TTs in small children provides a reliably sealed airway at cuff pressures of <or=20 cm H(2)O, reduces the need for TT exchanges, and does not increase the risk for post-extubation stridor compared with uncuffed TTs.
Patients aged from birth to 5 yr requiring general anaesthesia with TT intubation were included in 24 European paediatric anaesthesia centres. Patients were prospectively randomized into a cuffed TT group (Microcuff PET) and an uncuffed TT group (Mallinckrodt, Portex, Rüsch, Sheridan). Endpoints were incidence of post-extubation stridor and the number of TT exchanges to find an appropriate-sized tube. For cuffed TTs, minimal cuff pressure required to seal the airway was noted; maximal cuff pressure was limited at 20 cm H(2)O with a pressure release valve. Data are mean (SD).
A total of 2246 children were studied (1119/1127 cuffed/uncuffed). The age was 1.93 (1.48) yr in the cuffed and 1.87 (1.45) yr in the uncuffed groups. Post-extubation stridor was noted in 4.4% of patients with cuffed and in 4.7% with uncuffed TTs (P=0.543). TT exchange rate was 2.1% in the cuffed and 30.8% in the uncuffed groups (P<0.0001). Minimal cuff pressure required to seal the trachea was 10.6 (4.3) cm H(2)O.
The use of cuffed TTs in small children provides a reliably sealed airway at cuff pressures of <or=20 cm H(2)O, reduces the need for TT exchanges, and does not increase the risk for post-extubation stridor compared with uncuffed TTs.
Mots-clé
Air Pressure, Anesthesia, General, Child, Preschool, Device Removal, Equipment Design, Female, Humans, Infant, Infant, Newborn, Intubation, Intratracheal/adverse effects, Intubation, Intratracheal/instrumentation, Male, Postoperative Complications, Prospective Studies, Respiratory Sounds/etiology, Treatment Outcome
Pubmed
Web of science
Création de la notice
01/11/2018 17:33
Dernière modification de la notice
20/08/2019 13:15
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