endotracheal tube

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within the trachea.
endotracheal tube an airway catheter inserted in the trachea during endotracheal intubation to assure patency of the upper airway by allowing for removal of secretions and maintenance of an adequate air passage. Endotracheal intubation may be accomplished through the mouth using an orotracheal tube, or through the nose using a nasotracheal tube. Numerous different endotracheal tubes are available. Tubes for adults are almost always “cuffed” to prevent air and aspiration leakage and allow for their use with a mechanical ventilator. (Pediatric tubes are not cuffed, since the airway is narrower at the distal end.) The cuff is a balloonlike device that fits over the lower end of the tube and is attached to a narrow tube that extends outside the body and allows for inflation of the cuff. Once the cuff is inflated there is no flow of air through the trachea other than that going through the endotracheal tube. Care should be taken not to overinflate the cuff.

Passage of an endotracheal tube during surgery is a well-established and long-used technique. In recent years the procedure has become a part of medical management of ventilatory failure as an alternative to tracheotomy. Tube placement is verified by watching the tube pass through the vocal cords, listening to the lungs and stomach, and checking it radiographically within one hour of placement. Adjunct techniques such as capnometry and pulse oximetry can also be used to verify placement. Endotracheal intubation has the advantages of not requiring a surgical procedure as does tracheotomy, of removal of the tube (extubation) being less involved, and of the procedure being able to be repeated as necessary.

The endotracheal tube cannot be used for long-term relief of ventilatory failure. A tracheostomy is required for long-term ventilator-dependent patients.

Complications of endotracheal intubation include damage to the vocal cords, erosion, and eventual stricture of the larynx. Pulmonary infections may result from interference with the normal protective mechanisms of the glottis and from the introduction of pathogenic organisms into the respiratory tract and difficulty in their removal by coughing.
Patient Care. The respiratory apparatus for assisted ventilation must be stabilized. Secure anchoring of the tube and apparatus is necessary to prevent tension on or misplacement of the tube. Its position is checked periodically by auscultation, chest x-ray, or capnography.

The inhaled air must be adequately humidified; the normal humidifying function of the upper respiratory tract is not present because the tube bypasses that area. Inhaled air must also be protected from contamination as much as possible. suctioning of secretions via the tube is done with gentleness and according to the basic guidelines established for this procedure. The patient will require mouth care and frequent observation for signs of pressure against the lips and nose. An emergency tracheotomy tray and an extra endotracheal tube are kept at the bedside. Since a patient with an endotracheal tube in place cannot talk, means must be arranged to assist with communication. During an emergency, medications that can be administered through the endotracheal tube include epinephrine, atropine, and lidocaine.
Suctioning an endotracheal tube. From Lammon et al., 1995.


a hollow cylindrical organ or instrument. adj., adj tu´bal.
auditory tube eustachian tube.
Blakemore-Sengstaken tube Sengstaken-Blakemore tube.
chest tube see chest tube.
Dobhoff tube a small-lumen feeding tube that can be advanced into the duodenum.
drainage tube a tube used in surgery to facilitate escape of fluids.
Drieling tube a double-lumen tube having a metal weight at one end to carry it past the stomach into the duodenum. At the other end are two tails, one used to collect gastric specimens and the other to collect specimens from the duodenum. The tube is used in the secretin test for pancreatic exocrine function.
Durham's tube a jointed tracheostomy tube.
endobronchial tube a single- or double-lumen tube inserted into the bronchus of one lung and sealed with an inflatable cuff, permitting ventilation of the intubated lung and complete deflation of the other lung; used in anesthesia and thoracic surgery.
endotracheal tube see endotracheal tube.
esophageal tube stomach tube.
eustachian tube see eustachian tube.
Ewald tube a large lumen tube used in gastric lavage.
fallopian tube see fallopian tube.
feeding tube one for introducing high-caloric fluids into the stomach; see also tube feeding.
tube feeding a means of providing nutrition via a feeding tube inserted into the gastrointestinal tract; it may be done to maintain nutritional status over a period of time or as a treatment for malnutrition. It can be used as the only source of nutrition or as a supplement to oral feeding or parenteral nutrition.

Patients who may require tube feeding include those unable to take in an adequate supply of nutrients by mouth because of the side effects of chemotherapy or radiation therapy, those with depression or some other psychiatric disorder, and those suffering from severe hypermetabolic states such as burns or sepsis, or malabsorption syndromes. Other conditions that may require tube feeding include surgery or trauma to the oropharynx, esophageal fistula, and impaired swallowing such as that which occurs following stroke or that related to neuromuscular paralysis.

There are commercially prepared formulas for tube feeding. Some contain all six necessary nutrients (carbohydrates, fats, proteins, vitamins, minerals, and trace elements) and need no supplement as long as they are given in sufficient volume to meet nutritional and caloric needs. Other types of tube feeding formulas are incomplete and therefore will require some supplementation. Choice of formula is based on the patient's particular needs, presence of organ failure or metabolic aberration, lactose tolerance, gastrointestinal function, and how and where the feeding is to be given, that is, via nasogastric, gastrostomy, or enterostomy tube.
Patient Care. In addition to frequent and periodic checking for tube placement and monitoring of gastric residuals to prevent aspiration, other maintenance activities include monitoring effectiveness of the feeding and assessing the patient's tolerance to the tube and the feeding. Special mouth care is essential to maintain a healthy oral mucosa. A summary of the complications related to tube feeding, their causes and contributing factors, and interventions to treat or prevent each complication is presented in the accompanying table.
fermentation tube a U-shaped tube with one end closed, for determining gas production by bacteria.
Levin tube a gastroduodenal catheter of sufficiently small caliber to permit transnasal passage; see illustration.
Two types of nasogastric tubes. From Ignatavicius et al., 1995.
Linton tube a triple-lumen tube with a single balloon used to control hemorrhage from esophageal varices. Once it is positioned under fluoroscopic control and inflated, the balloon exerts pressure against the submucosal venous network at the cardioesophageal junction, thus restricting the flow of blood to the esophageal varices.
Miller-Abbott tube see miller-abbott tube.
Minnesota tube a tube with four lumens, used in treatment of esophageal varices; having a lumen for aspiration of esophageal secretions is its major difference from the sengstaken-blakemore tube.
nasogastric tube see nasogastric tube.
nasotracheal tube an endotracheal tube that passes through the nose.
neural tube the epithelial tube produced by folding of the neural plate in the early embryo.
orotracheal tube an endotracheal tube that passes through the mouth.
otopharyngeal tube eustachian tube.
Rehfuss tube a single-lumen oral tube used to obtain specimens of biliary secretions for diagnostic study; it is weighted on one end so that it can be passed through the mouth and positioned at the point where the bile duct empties into the duodenum. See also biliary drainage test.
Salem sump tube a double-lumen nasogastric tube used for suction and irrigation of the stomach. One lumen is attached to suction for the drainage of gastric contents and the second lumen is an air vent. See illustration.
Sengstaken-Blakemore tube see sengstaken-blakemore tube.
stomach tube see stomach tube.
T-tube one shaped like the letter T and inserted into the biliary tract to allow for drainage of bile; it is generally left in place for 10 days or more in order to develop a tract through which bile can drain after the tube is removed. A T-tube cholangiogram is usually performed prior to removal of the tube in order to determine that the common duct is patent and free of stones. If stones are found they can be removed through the tube tract by instruments inserted under x-ray guidance.
test tube a tube of thin glass, closed at one end; used in chemical tests and other laboratory procedures.
thoracostomy tube a tube inserted through an opening in the chest wall, for application of suction to the pleural cavity; used to drain fluid or blood or to reexpand the lung in pneumothorax. See also chest tube.
tracheal tube endotracheal tube.
tracheostomy tube a curved endotracheal tube that is inserted into the trachea through a tracheostomy; see discussion under tracheostomy.
tympanostomy tube ventilation tube.
uterine tube fallopian tube.
ventilation tube a tube inserted after myringotomy in chronic cases of middle ear effusion, such as in secretory or mucoid otitis media; it provides ventilation and drainage for the middle ear during healing, and is eventually extruded. Called also tympanostomy tube.
Tympanostomy (ventilation) tube. Polyethylene tubes are inserted surgically into the eardrum to relieve middle ear pressure and promote drainage of chronic or recurrent middle ear infections. Tubes extrude spontaneously in 6 months to 1 year. From Jarvis, 1996.
Wangensteen tube a small nasogastric tube connected with a special suction apparatus to maintain gastric and duodenal decompression.
Whelan-Moss T-tube a t-tube whose crossbar tube is larger in diameter than the drainage tube.
x-ray tube a glass vacuum bulb containing two electrodes; electrons are obtained either from gas in the tube or from a heated cathode. When suitable potential is applied, electrons travel at high velocity from cathode to anode, where they are suddenly arrested, giving rise to x-rays.

en·do·tra·che·al tube

a flexible tube inserted nasally, orally, or through a tracheostomy into the trachea to provide an airway, as in tracheal intubation.

endotracheal tube

a large-bore catheter inserted through the mouth or nose and into the trachea to a point above the bifurcation of the trachea. It is used for delivering oxygen under pressure when ventilation must be totally controlled and in general anesthetic procedures. See also endotracheal intubation.
enlarge picture
Endotracheal tube

tra·che·al tube

(trā'kē-ăl tūb)
A flexible tube inserted nasally, orally, or through a tracheotomy into the trachea to provide an airway, as in tracheal intubation.
Synonym(s): endotracheal tube.

endotracheal tube

(en?do-tra'ke-al) [? + ?],


Enlarge picture
A catheter inserted into the trachea to provide or protect an airway. See: illustration Synonym: tracheal tube; intubation tube


Although an ET is often thought to be the most secure and definitive airway, its use in emergencies may be complicated by misplacement (e.g., in the esophagus instead of in the trachea), displacement (e.g., during patient transport), or injury to the airway.

endotracheal tube

A curved plastic tube, some 20–25 cm long, inserted through the mouth into the upper part of the windpipe (trachea), by way of the voice-box (larynx) so as to maintain a reliable AIRWAY in an anaesthetized or otherwise unconscious person. Most endotracheal tubes are cuffed with a small balloon that can be inflated to form a seal and prevent inhalation of secretions or vomit.

Endotracheal tube

A metal or plastic tube inserted in the windpipe which may be attached to a ventilator. It also may be used to deliver medications such as surfactant.


within the trachea.

Cole-pattern endotracheal tube
one with a tapered shape with no cuff; designed to be fitted with a wider shoulder at the larynx and narrow end in the trachea. Used in horses.
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Cole-pattern endotracheal tube. By permission from Hall L, Clarke KW, Trim C, Veterinary Anaesthesia, Saunders, 2000
endotracheal intubation
an airway catheter inserted in the trachea during endotracheal intubation to assure patency of the upper airway by allowing for removal of secretions and maintenance of an adequate air passage. In animals, endotracheal intubation is usually accomplished through the mouth using an orotracheal tube.
nasal endotracheal tube
an endotracheal tube designed to be passed through the nasal cavity into the trachea. It usually has a thin wall.
reinforced endotracheal tube
a spiral wire or nylon strip is incorporated into the wall to reduce the risk of collapse or kinking.
endotracheal tube
a variety of endotracheal tubes is available. The tubes are almost always 'cuffed' to allow for their use with a mechanical ventilator. The cuff is a rubber balloon-like device that fits over the lower end of the tube. It is attached to a narrow tube that extends outside the body and allows for inflation of the cuff. Once the cuff is inflated there is no flow of air through the trachea other than that going through the endotracheal tube.