Abstract
Background: Displacement of endotracheal tube (ETT) can result in endobronchial intubation and accidental extubation that severely threatens safety of surgical patients. However, few surveys have investigated intraoperative ETT displacement experienced by anesthesiologists. The objective of these surveys was to investigate ETT fixation method and ETT displacement during general anesthesia experienced by anesthesiologists in China in 2014 and 2020. Methods: A questionnaire was designed with twenty questions and randomly distributed to anesthesiologists in two survey methods. In 2014, we collected responses from anesthesiologists who participated in the 22nd annual meeting of the Chinese Society of Anesthesiology in a face-to-face setting; in 2020, anesthesiologists from twenty-eight provinces completed the questionnaire through an online questionnaire survey platform. Differences in the responses from the anesthesiologists in 2014 and 2020 were assessed with a chi-square test. Results: In total, 568 questionnaires were collected, of which 541 questionnaires were valid (valid response rate 95.2%). A majority of the respondents (65.6%) had experienced ETT displacement, and 4.3% of respondents had experienced serious complications due to ETT displacement. Three hundred and twenty-nine respondents (60.8%) fixed the ETT with adhesive tape in the shape of the letter X. A majority of respondents considered the influence of surgical site, body position (97.8% of all respondents), and age (77.1% of all respondents) on fixing the ETT. Adhesive tape was the most commonly used material to fix the ETT (90.4% of the respondents). Conclusion: During clinical anesthesia, a majority of anesthesiologists experienced ETT displacement that can result in serious consequences. Therefore, the management of ETT should be a priority during the operation.
Highlights
Securing the endotracheal tube (ETT) following intubation is a routine procedure during general anesthesia with tracheal intubation
The case reports of accidental extubation during general anesthesia can still be found in recent years [7] [15] [16] [17] [18] [19], the cases of ETT displacement and its consequences might be underestimated in the literature
The questionnaire consisted of twenty questions, which involved the characteristics of respondents, the ETT fixation methods, the ETT displacement and its consequences experienced by the anesthesiologists, and the factors influencing the anesthesiologists to determine the method of fixing the ETT
Summary
Securing the endotracheal tube (ETT) following intubation is a routine procedure during general anesthesia with tracheal intubation. Proper fixation of the ETT is crucial for effective ventilation during general anesthesia while minimizing potential complications due to ETT displacement. Displacement of the ETT can result in endobronchial intubation and accidental extubation [1]. The case reports of accidental extubation during general anesthesia can still be found in recent years [7] [15] [16] [17] [18] [19], the cases of ETT displacement and its consequences might be underestimated in the literature. Displacement of endotracheal tube (ETT) can result in endobronchial intubation and accidental extubation that severely threatens safety of surgical patients. Few surveys have investigated intraoperative ETT displacement experienced by anesthesiologists.
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