TYPES OF ETT.pdf

n

1. BY. Mosa Alfageh
Material of ETT
AND
Special types of ETT

2. STANDARD ENDOTRACHEAL TUBE DESIGN
1.Patient End
2.Curvature
3.Markings
4.Material
5.Size
6.Tube Cuff
7.Machine End

3. Material
1.Red Rubber/Natural Latex
•Reusable
•Rigid
•Less traumatic
•Opaque
•Repatedwashing makes it soft & kinkable
•Can be allergic
2. PVC
•Inexpensive
•Compatible with tissue
•Disposable
•Presterilised
•Transparent
•Rigid
•Difficult to insert
•Traumatic
3. Silicon Ruber
•PVC+SiliconOil
•Less surface adhesion
•Opaque
•Inexpensive
•Can be reused after autoclaving

4. SPECIAL TUBES
1. Cole Type: Emergency Neonatal Resucitation
: Narrow Patient end
: Shoulder prevents bronchealintubation & provides air tight seal
: Size is same as ID of patient end.
: Can get blocked easily.
: Resistance offered is more than normal ET tube of same size.

5. 2. Microcuff ET tube
: cuffed tube for children
: Short ultrathin cuff away from subglottic area
:Can be inflated at very less pressure
: No murphy's Eye
: So cuff can be placed too distal
: Reduced risk of pressure to Cricoid.

6. 3.RAE type: Ring AdainElwin Tube
: Oral/South Polar RAE
: Nasal/North Polar RAE
: Used to facilitate surgeries of
Head & face.
: South polar RAE has connector placed towradschin giving better
view during cleft palate surgeries.
: North polar RAE is nasal so connector placed away from jaw giving
better access to mandible.
: Have disadvantage of not being able to pass suction catheter
through it.

7. 4. Flexometalic tube : Head & Neck surgery with high movements
: Reinforced with wire within the tube.
: Flexible & Non kinking
: More esily slipped over fibreoptic broncoscope
: No nasal entubation possible
: No Murphy's Eye
: Expensive
: Spontaneous extubation can
happen
: May obstruct the radiological
view of Cx Spine

8. 6. Microlaryngeal Tube : Microlaryngeal surgeries & with narrow airway.
: Available as 4,5 or 6 sized tube.
: High volume low pressure cuff.
: Can be inserted through LMA
: Forcep is required during intubation.

9. 7. Tehran tube : specially designed for nasal intubation
: Have a typical upper airway curve.
: Reusable.
: Made of silicon.
: Can be inserted blindly.

10. 8. Laryngectomy Tube
: Designed to be inserted through
tracheostomy
: J shaped.
: To be made straight before
intubation
: No bevel end.

11. 8. Endotrol Tube: Has a trigger loop.
: Pulling the trigger lead to decrease in inter radius of tube.
: Facilitate blind nasal intubation.
: For surgeries suspecting cervical spine injury

12. 9. EndoFlex® Tube
: Almost same as endotrol tube.
: Pulling the white bar causes tube tio to bend anteriorily.
: Facilitates intubation in patient with anteriorly placed larynx

13. 10. Parker Flex-Tip® Tube: Hooded tip.
: Flexible distal end.
: Best to go with bronchoscope.
: Available with or without Murphy's Eye.

14. 11. Electromyogram Reinforced Tracheal Tube
: To monitor RLN electromyogram during surgery.
: Wired reinforcement.
: Four electrodes above cuff.

15. 12. Intubating Laryngeal Mask Tracheal Tube
: Specially designed to be used with LMA.
: Wire reinforced sicon tube.
: Available in 6,6.5, 7 & 7.5 sizes.
: Reusable.
: Separately used in sub-
mental intubation.
: eccentric cuff inflation.
: MRI Compatible.

16. 13. Hi-Lo Evac® Tube: Dedicated channel.
: To facilitate suction during surgery.
: Suction the are above cuff and below vocal cord.
: Lumen may be blocked by secretion.

17. 14. Hi-Lo Jet Tube : Uncuffed tube with additional lumen.
: Jet ventilation.
: Monitoring airway pressure.
: Sampling respiratory gases.
: Administering LA.
: Irrigating the airway.
: Suction through main tube is
difficult.

18. 15. Laser-Resistant Tubes
15. LASER Resistant tubes.

19. 16. Double Lumen Tubes: Used to isolate lung during CTVS surgeries
: Prevents contamination of contralateral lung.
: Achieve independent lung ventilation in unilateral
parenchymal injury and bronchopulmonary fistula.