Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=26983051
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
A Comparison of the Haider Tube-Guard® Endotracheal Tube Holder Versus Adhesive
Tape to Determine if This Novel Device Can Reduce Endotracheal Tube Movement and
Prevent Unplanned Extubation
#MMPMID26983051
Buckley JC
; Brown AP
; Shin JS
; Rogers KM
; Hoftman NN
Anesth Analg
2016[May]; 122
(5
): 1439-43
PMID26983051
show ga
BACKGROUND: Endotracheal tube security is a critical safety issue. We compared
the mobility of an in situ endotracheal tube secured with adhesive tape to the
one secured with a new commercially available purpose-designed endotracheal
tube-holder device (Haider Tube-Guard). We also observed for the incidence of
oropharyngeal or facial trauma associated with the 2 tube fixation methods.
METHODS: Thirty adult patients undergoing general anesthesia with neuromuscular
blockade were prospectively enrolled. Immediately after intubation, a single
study author positioned the endotracheal tube tip in the distal trachea using a
bronchoscope. Anesthesiologists caring for patients secured the tube in their
normal fashion (always with adhesive tape). A force transducer was used to apply
linear force, increasing to 15 N or until the principal investigator deemed that
the force be aborted for safety reasons. The displacement of the endotracheal
tube was measured with the bronchoscope. Any tape was then removed and the
endotracheal tube secured with the Haider Tube-Guard device. The linear force was
reapplied and the displacement of the endotracheal tube measured. The Haider
Tube-Guard device was left in place for the duration of the case. The patient's
face and oropharynx were examined for any evidence of trauma during surgery and
in the recovery room. On discharge from the postanesthesia care unit, the patient
answered a brief survey assessing for any subjective evidence of minor facial or
oropharyngeal trauma. RESULTS: Under standardized tension, the endotracheal tube
withdrew a mean distance of 3.4 cm when secured with adhesive tape versus 0.3 cm
when secured with the Haider Tube-Guard (P <0.001). Ninety-seven percent of
patients (29/30) experienced clinically significant endotracheal tube movement
(>1 cm) when adhesive tape was used to secure the tube versus 3% (1/30) when the
Haider Tube-Guard was used (P <0.001). Thirty percent of patients (9/30) were
potentially deemed a high extubation risk (endotracheal tube movement >4 cm) when
the endotracheal tube was secured with tape versus 0% (0/30) when secured with
the Haider Tube-Guard (P = 0.004). Six patients with taped endotracheal tubes
required the traction to be aborted before 15 N of force was achieved to prevent
potential extubation as the tape either separated from the face or stretched to
allow excessive endotracheal tube movement. None of the patients appeared to
sustain any injury from the Haider Tube-Guard device. CONCLUSIONS: The Haider
Tube-Guard significantly reduced the mobility of the endotracheal tube when
compared with adhesive tape and was well tolerated in our observations.
|*Airway Extubation
[MESH]
|*Chest Tubes
[MESH]
|*Surgical Tape/adverse effects
[MESH]
|Anesthesia, General
[MESH]
|Bronchoscopy
[MESH]
|Equipment Design
[MESH]
|Facial Injuries/etiology
[MESH]
|Foreign-Body Migration/etiology/*prevention & control
[MESH]
free
free
free
