Is endotracheal tube displacement during head and neck extension due to ascending movement or tracheal lengthening? An observational ultrasonographic study
Authors' conclusion
In conclusion, the ETT cuff displaced toward the larynx in a less degree than the tip did from the carina due to the tracheal lengthening during head and neck extension.
Study context
- Population
- Patients scheduled for thyroidectomy
- Participants
- 62 patients
- Exposure
- Head and neck extension vs flexion
- Outcome
- Endotracheal tube (ETT) cuff movement relative to laryngeal structures (cricoid cartilage to upper cuff margin, CC, by ultrasonography) and tip displacement from the carina (TC, by fiberoptic bronchoscopy)
Main finding
As reported in the abstract
CC, TC and total tracheal length (TTL)
The carina (TC) change
2.1 cm
TC increased; ± 1.0
CC change
0.6 cm
CC decreased; ± 0.7
Total tracheal length (TTL) change
1.4 cm
TTL lengthened; ± 1.1
Flexion
1.5
mean · SD 0.6 · cm
Observational data: associations, not effects.
Further findings
Excessively deep intubation during flexion
- Patients with excessively deep intubation during flexion
- 7 (11.7%)
Tip position corrected after ultrasound-guided cuff adjustment (CC = 0)
- Tip position corrected
- 96.7%
Excessive cuff displacement beyond the cricoid cartilage in extension
- Patients with excessive cuff displacement beyond the cricoid cartilage
- 4 (6.7%)
- Could have been corrected under ultrasonography
Original publication
Is endotracheal tube displacement during head and neck extension due to ascending movement or tracheal lengthening? An observational ultrasonographic study. J Clin Monit Comput. Published 26 May 2022. doi:10.
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