endotracheal


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endotracheal

 [en″do-tra´ke-al]
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.

en·do·tra·che·al

(en'dō-trā'kē-ăl),
Within the trachea.

endotracheal

/en·do·tra·che·al/ (en″do-tra´ke-al) within or through the trachea.

endotracheal

(ĕn′də-trā′kē-əl)
adj.
Within or passing through the trachea: an endotracheal tube.

endotracheal

[en′dōtrā′kē·əl]
Etymology: Gk, endon + tracheia + arteria, airpipe
within or through the trachea.

en·do·tra·che·al

(en'dō-trā'kē-ăl)
Within the trachea.

endotracheal

Within the windpipe (TRACHEA).

Endotracheal

Placed within the trachea, also known as the windpipe.

en·do·tra·che·al

(en'dō-trā'kē-ăl)
Within the trachea.

endotracheal

(en´dōtrā´kēəl),
adj describes placement of an object within the trachea, or windpipe. E.g., an endotracheal tube is placed in the trachea and acts as an artificial airway.

endotracheal

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.
Enlarge picture
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.
References in periodicals archive ?
Conclusion: Reinforced laryngeal mask airway seems a safe and logical substitute for endotracheal tube in adult tonsillectomy in experienced hands.
Berlauk JF 1986 Prolonged endotracheal intubation vs.
Such failure can occur secondary to poor technique, to variations in supraglottic and tracheal anatomy, and to a circumstance in which the tip of the endotracheal tube becomes hung up on the epiglottis, the right arytenoid cartilage, or other soft-tissue structures of the larynx.
Laryngotracheal stenosis (LTS) is usually found in patients with a history of endotracheal intubation.
We don't go for an endotracheal intubation if it is hard.
Immediately, after endotracheal intubation or laryngeal mask insertion there was a significant increase in systolic blood pressure in both the groups.
Patients for whom consent was not given for endotracheal intubation were also excluded.
In this study, we compared effect of Macintosh and Airtraq laryngoscopes on intubating conditions in patients at increased risk for difficult tracheal intubation by observing intubation time, intubation attempts, associated complications, other manipulations required during intubation, success rate of endotracheal intubation and lowest SpO2 during intubation.
Generalised estimating equation analysis showed a significant positive association between application of lidocaine gel on endotracheal tube and severity of sore throat (p<0.
In this study, the clinical outcome of replacing a conventional endotracheal tube with endotracheal tube with subglottic suction port were scrutinized.
Estimation of the optimum length of endotracheal tube insertion in adults *