Anendotracheal tubeis a flexible tube that is placed in thetrachea(windpipe) through the mouth or nose.
Medications and numbing sprays can help reduce discomfort and make the placement of the tube easier.
However, endotracheal tubes can cause side effects like vocal hoarseness and sore throat.
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When used for a prolonged time, severe complications like pneumonia and collapsed lung may occur.
Why Are Endotracheal Tubes Used?
An endotracheal tube is often used during surgery and in emergency situations.
It is typically placed when a person is unable to breathe on their own.
The placement of the tube is called endotracheal intubation.
An endotracheal tube may have one or two channels, known aslumens.
Endotracheal tubes come in different sizes ranging from 2.0 to 10.5 millimeters (mm) in diameter.
The bigger tubes are used for larger adults and the smallest ones are used for premature babies.
At the end of most endotracheal tubes is an inflatable balloon called aballoon cuff.
The cuff is inflated to keep the tube securely in place in the mouth after intubation.
Pillows or padding may be placed under the person’s head or neck to make airway access easier.
Secretions may be suctioned occasionally to keep the tube clear.
If indications are good, the tape holding the tube on the face is removed.
The balloon cuff is then deflated, and the tube is firmly and steadily pulled out.
The removal may feel odd, but it is usually not painful.
Side Effects and Risks of Endotracheal Tubes
A sore throat is common following endotracheal intubation.
It usually lasts a few days.
Around one-third to half of people who have been intubated experience vocal hoarseness for up to a week.
Less than 1% have hoarseness for longer than a week.
Other people may need intubation and mechanical ventilation longer due to a severe or critical illness.
Even so, the tube cannot be left indefinitely and should be removed within 14 days.
Leaving it in any longer can cause the thinning of cartilage and the narrowing of the airway passage.
Intravenous feeding through a vein (total parenteral nutrition) may also be used.
Others with serious medical conditions may need a feeding tube placed through a hole in their abdomen.
Summary
There are many uses for endotracheal intubation.
Common side effects like hoarseness or sore throat typically clear within a few days.
The risk of serious complications like pneumonia increases if intubation is needed for more than seven days.
Haas CF, Eakin RM, Konkle MA, Blank R.Endotracheal tubes: old and new.Respiratory Care.
Ingelfinger JR, ed.N Engl J Med.
2021;385(16):e52.
doi:10.1056/NEJMvcm2026684
Ahmed RA, Boyer TJ.Endotracheal tube.
In: StatPearls [Internet].
Treasure Island (FL): StatPearls Publishing; Jan 2022.
American Society of Anesthesiologists.Smoking.
Cochrane Oral Health Group, ed.Cochrane Database of Systematic Reviews.
2016;11(11):CD011136.
doi:10.1002/14651858.CD011136.pub2
Touman AA, Stratakos GK.Long-term complications of tracheal intubation.Tracheal Intubation.
- doi:10.5772/intechopen.74160
Yale Medicine.Ventilators and COVID-19: What it’s crucial that you Know, June 2, 2020.
National Library of Medicine.
2018 Jun 10;2018:5649476. doi:10.1155/2018/5649476
