Tracheal tubes Tracheal intubation
a cuffed endotracheal tube, constructed of polyvinyl chloride
a carlens double-lumen endotracheal tube, used thoracic surgical operations such vats lobectomy
a tracheal tube catheter inserted trachea primary purpose of establishing , maintaining patent (open , unobstructed) airway. tracheal tubes used airway management in settings of general anesthesia, critical care, mechanical ventilation , emergency medicine. many different types of tracheal tubes available, suited different specific applications. endotracheal tube specific type of tracheal tube inserted through mouth (orotracheal) or nose (nasotracheal). breathing conduit designed placed airway of critically injured, ill or anesthetized patients in order perform mechanical positive pressure ventilation of lungs , prevent possibility of aspiration or airway obstruction. endotracheal tube has fitting designed connected source of pressurized gas such oxygen. @ other end orifice through such gases directed lungs , may include balloon (referred cuff). tip of endotracheal tube positioned above carina (before trachea divides each lung) , sealed within trachea lungs can ventilated equally. tracheostomy tube type of tracheal tube; 2–3-inch-long (51–76 mm) curved metal or plastic tube inserted tracheostomy stoma or cricothyrotomy incision.
tracheal tubes can used ensure adequate exchange of oxygen , carbon dioxide, deliver oxygen in higher concentrations found in air, or administer other gases such helium, nitric oxide, nitrous oxide, xenon, or volatile anesthetic agents such desflurane, isoflurane, or sevoflurane. may used route administration of medications such bronchodilators, inhaled corticosteroids, , drugs used in treating cardiac arrest such atropine, epinephrine, lidocaine , vasopressin.
originally made latex rubber, modern endotracheal tubes today constructed of polyvinyl chloride. tubes constructed of silicone rubber, wire-reinforced silicone rubber or stainless steel available special applications. human use, tubes range in size 2 10.5 mm (0.1 0.4 in) in internal diameter. size chosen based on patient s body size, smaller sizes being used infants , children. endotracheal tubes have inflatable cuff seal tracheobronchial tree against leakage of respiratory gases , pulmonary aspiration of gastric contents, blood, secretions , other fluids. uncuffed tubes available, though use limited children (in small children, cricoid cartilage narrowest portion of airway , provides adequate seal mechanical ventilation).
in addition cuffed or uncuffed, preformed endotracheal tubes available. oral , nasal rae tubes (named after inventors ring, adair , elwyn) used of preformed tubes.
there number of different types of double-lumen endo-bronchial tubes have endobronchial endotracheal channels (carlens, white , robertshaw tubes). these tubes typically coaxial, 2 separate channels , 2 separate openings. incorporate endotracheal lumen terminates in trachea , endobronchial lumen, distal tip of positioned 1–2 cm right or left mainstem bronchus. there univent tube, has single tracheal lumen , integrated endobronchial blocker. these tubes enable 1 ventilate both lungs, or either lung independently. single-lung ventilation (allowing lung on operative side collapse) can useful during thoracic surgery, can facilitate surgeon s view , access other relevant structures within thoracic cavity.
the armored endotracheal tubes cuffed, wire-reinforced silicone rubber tubes. more flexible polyvinyl chloride tubes, yet difficult compress or kink. can make them useful situations in trachea anticipated remain intubated prolonged duration, or if neck remain flexed during surgery. armored tubes have magill curve, preformed armored rae tubes available. type of endotracheal tube has 4 small openings above inflatable cuff, can used suction of trachea or administration of intratracheal medications if necessary. other tubes (such bivona fome-cuf tube) designed use in laser surgery in , around airway.
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