critical care medicine
Airway and Respiratory Devices
Endotracheal Tubes
An endotracheal tube is inserted directly into the trachea via the mouth or, less commonly, the nose. Endotracheal tubes have high-volume, low-pressure balloon cuffs to prevent air leakage and minimize the risk of aspiration. Cuffed tubes were traditionally used only in adults and children>8 years; however, cuffed tubes sometimes are used in infants and younger children to limit air leakage or aspiration (particularly during transport). Sometimes cuffs are not inflated or inflated only to the extent needed to prevent obvious leakage. An endotracheal tube is the definitive method to secure a compromised airway, limit aspiration, and initiate mechanical ventilation in comatose patients, in patients who cannot protect their own airways, and in patients who need prolonged Overview of Mechanical Ventilation . An endotracheal tube also permits suctioning of the lower respiratory tract. Although drugs can be delivered via an endotracheal tube during Placement typically requires laryngoscopy by a skilled practitioner, but a variety of novel insertion devices that provide other options are available (see Tracheal Intubation ). 