Abstract
The extent of endotracheal tube (ETT) migration was studied in 25 adult female patients undergoing robotic-assisted laparoscopic gynecologic surgery while in a steep Trendelenburg position secured with the Estape TrenMAX positioning system (Innovative Medical Products, Plainville, CT, USA). In four patients, the distance from the tip of the ETT to the carina did not change. In three patients, the distance from the tip of the ETT to the carina decreased by 1 centimeter (cm). In other patients, the distance from the tip of the ETT to the carina decreased by 0.2 to 0.5 cm. We concluded that the tip of the ETT moves closer to the carina in patients put in the extreme Trendelenburg position. These results were in alignment with the evidence base created by other researchers.
Highlights
Artificial airway placement and maintenance are critical activities performed daily by anesthesiologists in the operating room (OR)
The sample included 25 patients admitted for robotic-assisted laparoscopic gynecologic surgery at Larkin Community Hospital (LCH)
The data obtained in this research project is comparable to the data reported in other sources, exact comparisons are difficult due to the scarcity of evidence and statistical data on endotracheal tube (ETT) migration in patients placed in the extreme Trendelenburg position [1,5]
Summary
Artificial airway placement and maintenance are critical activities performed daily by anesthesiologists in the operating room (OR). An inadequately advanced ETT is as dangerous as one that is advanced too deep into the trachea [1] The former increases the likelihood of accidental extubation during surgery; the latter can lead to endobronchial intubation, resulting in adverse events such as barotrauma [1,2]. For these reasons, anesthesiologists look for ways to reduce the extent of ETT migration or at least minimize the adverse effects of such migration. Various tapes and tube holders have been evaluated for their effectiveness in preventing ETT migration [6]
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