Endotracheal Tube Migration Associated With Extension During Tracheotomy.

In this study, changes in the position of the endotracheal tube tip during extension of the head and neck for a tracheotomy were investigated. Twelve patients underwent placement of a tracheotomy during surgical procedures for oral cancer. After nasal intubation, the distance between the tube tip and the carina was measuring using a fiberoptic scope with the patient's head placed at an angle of 110°. Patients were repositioned for tracheotomy by placing a pillow under the shoulders and extending the head and neck at an angle of 140°. The distance measurements were subsequently repeated. The difference between the first and second measurements was calculated and analyzed statistically using a paired t test. On average the patients were 69.5 ± 9.0 years in age. The distance between the tube tip and the carina at an angle of 140° (3.6 ± 1.1 cm) was significantly longer than that at an angle of 110° (1.7 ± 1.0 cm) (p < 0.001). The migration in the positioning of the endotracheal tube tip was 1.9 ± 0.7 cm (range: 0.7-3.7 cm) upon extension. In 3 cases, the tube cuff was ruptured during incision of the trachea. The endotracheal tube tip may migrate in the cephalad direction approximately 2 cm as a result of the extension of the patient's head and neck during a tracheotomy. Therefore, consideration should be given to advancing the endotracheal tube tip towards the caudal side and to confirming the position of the tube and cuff during a tracheotomy. PMID: 32191508 ...
Source: Anesthesia Progress - Category: Anesthesiology Tags: Anesth Prog Source Type: research