Cuffed endotracheal tubes in the PICU

Abstract

Traditional teaching has been to use plain endotracheal tubes in children ventilated in the pediatric intensive care unit (PICU) because of concern about the risk of laryngeal/subglottic injury. This traditional approach does not reflect the availability of modern endotracheal tubes with low-pressure cuffs, which are being used in some PICUs, apparently with good results. Newth et al in Los Angeles report their retrospective results in this issue of The Journal. In a large series of patients, they found no difference in the rate of complications between cuffed and uncuffed tubes and recommend a re-evaluation of current approaches.Page 333 Traditional teaching has been to use plain endotracheal tubes in children ventilated in the pediatric intensive care unit (PICU) because of concern about the risk of laryngeal/subglottic injury. This traditional approach does not reflect the availability of modern endotracheal tubes with low-pressure cuffs, which are being used in some PICUs, apparently with good results. Newth et al in Los Angeles report their retrospective results in this issue of The Journal. In a large series of patients, they found no difference in the rate of complications between cuffed and uncuffed tubes and recommend a re-evaluation of current approaches. Page 333