Abstract
The present study was conducted to investigate changes in uncuffed endotracheal tube (ETT) leak during laparoscopic surgery. The study included 31 patients aged between 1 and 6 years scheduled for elective laparoscopic inguinal herniorrhaphy. Inspiratory and expiratory tidal volumes (TVi and TVe) were measured during mechanical ventilation, and ETT leak was calculated using the formula—ETT leak = (TVi − TVe)/TVi × 100 (%), assessed at the following time-points—5 min after the start of mechanical ventilation (T1, baseline), just before the start of surgery (T2), 5 min after the induction of pneumoperitoneum with 15° Trendelenburg tilt (T3), and at the end of surgery (T4). Additionally, leak pressure was assessed after successful tracheal intubation (T0, baseline) at T2, T3 and T4. Uncuffed ETT leak significantly decreased at T3 compared with T1 (baseline). Leak pressure significantly increased at T3 and T4 compared with T0 (baseline). Further studies are needed in order to determine whether the results are universal and associated with clinically significant outcomes.
Similar content being viewed by others
References
Lasersohn L. Anaesthetic considerations for paediatric laparoscopy. S Afr J Surg. 2011;49:22–6.
Kuratani N. Anesthetic management of laparoscopic surgery for infants and children. J Jpn Soc Clin Anesth. 2008;28:573–7.
Coté CJ. Pediatric Anesthesia. In: Miller RD, Cohen NH, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL, editors. Miller’s anesthesia. 8th ed. Philadelphia: Churchill Livingstone; 2014. p. 2757–98.
Hung KC. To assess the changes of tracheal cuff pressure after a calibrating orogastric tube insertion. J Anesth. 2014;28:128–31.
Kato N, Takimoto H, Sudo N. The cubic functions for spline smoothed L, S and M values for BMI reference data of Japanese children. Clin Pediatr Endocrinol. 2011;20:47–9.
Eleanor M, Rosemary C, Janet S, Ian J, David H. The influence of endotracheal tube leak on the assessment of respiratory function in ventilated children. Intensive Care Med. 2001;27:1788–97.
Finholt DA, Henry DB, Raphaely RC. Factors affecting leak around endotracheal tubes in children. Can Anaesth Soc J. 1985;32:326–9.
Wu CY, Yeh YC, Wang MC, Lai CH, Fan SZ. Changes in endotracheal tube cuff pressure during laparoscopic surgery in head-up or head-down position. BMC Anesthesiol. 2014;14:75.
Kim JH, Hong DM, Oh AY, Han SH. Tracheal shortening during laparoscopic gynecologic surgery. Acta Anaesthesiol Scand. 2007;51:235–8.
Toung TJ, Grayson R. Saklad. J, Wang H. Movement of the distal end of the endotracheal tube during flexion and extension of the neck. Anesth Analg. 1985;64:1030–2.
Kim JH, Ro YJ, Min SW, Kim CS, Kim SD, Lee JH, Bahk JH. Elongation of the trachea during neck extension in children: implications of the safety of endotracheal tubes. Anesth Analg. 2005;101:974–7.
Hudgins PA, Siegel J, Jacobs I, Abramowsky CR. The normal pediatric larynx on CT and MR. Am J Neuroradiol. 1997;18:239–45.
Adewale L. Anatomy and assessment of the pediatric airway. Paediatr Anaesth. 2009;19(Suppl 1):1–8.
Jeff H, Ramesh R, Sanjay MB. Pediatric airway management. Int J Crit Illn Inj Sci. 2014;4:65–70.
Weiss M, Dullenkopf A, Fischer JE, Keller C, Gerber AC, European Paediatric Endotracheal Intubation Study Group. Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children. Br J Anaesth. 2009;103:867–73.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None.
About this article
Cite this article
Noguchi, A., Kuga, K., Tashiro, N. et al. Changes in uncuffed endotracheal tube leak during laparoscopic inguinal herniorrhaphy in children. J Anesth 30, 702–706 (2016). https://doi.org/10.1007/s00540-016-2190-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00540-016-2190-5