Article

An Improved Method for Endotracheal Intubation During Anesthesia

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Abstract

THE increasing use of endotracheal intubation during general anesthesia has made deficiencies apparent in the usual pattern of endotracheal catheters. For example, each of the numerous endotracheal tubes requires a correspondingly sized metal adapter for connection to the gas machine, and the adapter itself may be one of many shapes as well as types of slip-joint connectors. Whenever the adapter is placed within the endotracheal catheter, it reduces the size of the lumen of the catheter, causes turbulence in the gas flow and thereby increases resistance of the flow within the system. Currently used endotracheal catheters are made of rubber or heavy plastic. They are rather stiff and tend to kink when they are bent (Fig. 1a, a’). These nonpliable tubes predispose to sore throat and coughing and, also, through constant pressure cause ulceration and edema of the patient’s anterior tracheal wall1 and ulceration of the posterior laryngeal commissure. Furthermore, the continual rubbing of the rough catheter surfaces against these structures during respiratory movements, causes aggravation and occasionally granuloma formation.2,3

We have overcome these disadvantages by using a nonkinking endotracheal tube*, which at body temperature becomes pliable and adapts itself easily to the anatomic configuration of the upper respiratory tract (Fig. 1b, b’), yet which possesses the necessary rigidity for intubation. The tube is made of clear vinyl plastic of a high molecular weight. The method of construction is similar to that of a latex catheter. Each tube is individually molded on a form that is dipped into the coagulated. . .


 

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