Clinical recommendations to minimise problems with associated
with the use of endotracheal tubes.
- Pressure-check the endotracheal tube prior to use to assess for leaks
and problems with the pilot balloon (Merlin & Mileham, 2020). This is
especially true for reused endotracheal tubes.
- Use auscultation to aid in the detect of the minimal occlusive
pressure of the endotracheal tube cuff.
- Check the intracuff pressure after the first ten minutes of
anaesthesia to avoid reductions in the cuff pressure and potential
micro-leaks (Shin et al., 2018).
- Monitor the cuff pressure whenever the position of the neck has been
changed.
- Appreciate that it is possible to have a problem with the pilot
balloon or the inflation channel (Merlin & Mileham, 2020).
- Consider using a manometer to assist in monitoring cuff pressures.
- Consider replacing any ET tube that feels ‘snug’ during an initial
intubation.
Further recommendations can be reviewed at a previous clinical
commentary (Burns, 2020).
The clinical case reports such as this one, are important to disseminate
to the rest of the veterinary community. Not only have these authors
described the successful treatment of an anaesthesia associated
complication; this report also highlights some deficiencies that are
present in our anaesthetic management of tracheal intubation. Further
research into endotracheal tube selection and verification of cuff seal
are required.
Declarations
The author has no conflicts of interests to declare.
Acknowledgements
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