Abstract
Purpose
The endotracheal tube (ETT) constitutes a significant component of total airway resistance. However, a discrepancy between measured and theoretical values has been reported in airway resistance through ETTs. The causes of the discrepancy were estimated by physical and rheological simulations.
Methods
The pressure losses through total lengths of ETTs and slip joints under a volumetric flow rate of 30 L/min were measured, and the pressure losses through the tubular parts of ETTs with internal diameters (IDs) of 6.0-, 6.5-, 7.0-, 7.5-, and 8.0 mm were measured. The Reynolds number of each setting was calculated, and the pressure losses through the total length of the ETT, the tubular part, and the slip joint of each size of tube were estimated.
Results
The Reynolds numbers were >5000 in all sizes of ETTs. Measured pressure losses were larger in small sized ETTs than in large sized ETTs—520.9 Pascals (Pa) in 6.0-mm ID and 136.4 Pa in 8.0-mm ID tubes. The measured pressure losses through the tubular part were comparable to the predicted values. The measured pressure losses through the slip joints were larger than the predicted values, and they accounted for approximately 25–40% of total pressure losses of the ETTs.
Conclusion
Especially in small sized tubes, the pressure loss through the slip joint accounts for a large percentage of the total pressure loss through the ETT. The pressure loss through the slip joint may play a role in the discrepancy between measured and theoretical pressure losses through ETTs.
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Acknowledgments
The authors thank Mr. Hajime Tamitsu (dental technician, Department of Oral and Maxillofacial Surgery, Kindai University Hospital) for his help in moulding the slip joints.
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YT, KF and TO declare that there is no conflict of interest regarding the publication of this paper. KK and SM have been employed by Product Development Research Center, Daiken Medical Co. Ltd., Osaka, Japan.
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Takasugi, Y., Futagawa, K., Kazuhara, K. et al. Roles of endotracheal tubes and slip joints in respiratory pressure loss: a laboratory study. J Anesth 30, 789–795 (2016). https://doi.org/10.1007/s00540-016-2210-5
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DOI: https://doi.org/10.1007/s00540-016-2210-5