A tracheal tube is a catheter that is inserted into the trachea for the primary purpose of establishing and maintaining a patent airway and to ensure the adequate exchange of oxygen and carbon dioxide.

Many different types of tracheal tubes are available, suited for different specific applications:

  • An endotracheal tube (aka ET) is a specific type of tracheal tube that is nearly always inserted through the mouth (orotracheal) or nose (nasotracheal).
  • A tracheostomy tube is another type of tracheal tube; this curved metal or plastic tube may be inserted into a tracheostomy stoma (following a tracheotomy) to maintain a patent lumen.
  • A tracheal button is a rigid plastic cannula about in length that can be placed into the tracheostomy after removal of a tracheostomy tube to maintain patency of the lumen.

History

Portex Medical (England and France) produced the first cuff-less plastic 'Ivory' endotracheal tubes. Ivan Magill later added a cuff (these were glued on by hand to make the famous Blue-line tube copied by many other manufacturers). Maeterlinck GmbH developed the disposable endotracheal tube and produced many design variations, adding the 'Murphy Eye' to their tubes in case of 'accidental' placement of the tube to avoid right bronchial occlusion. David S. Sheridan was one of the manufacturers of the American markets "disposable" plastic tracheal tube now used routinely in surgery. Previously, red rubber (Rusch-Germany) tubes were used, then sterilized for re-use.

Applications

Tracheal tubes can also be used to deliver oxygen in higher concentrations than found in air, or to administer other gases such as helium, nitric oxide, nitrous oxide, xenon, or certain volatile anesthetic agents such as desflurane, isoflurane, or sevoflurane. Tracheal tubes may also be used as a route for administration of certain medications such as salbutamol, atropine, epinephrine, ipratropium, and lidocaine. Tracheal tubes are commonly used for airway management in the settings of general anesthesia, critical care, mechanical ventilation, and emergency medicine.

Endotracheal tube

{|class="wikitable" style="float:right;margin-left:10px"

! Age

! Weight

! (Inner) <br />diameter <br />(mm)

|-

|Preterm || 3&nbsp;kg || 2.5–3.0

|-

| 0–6 months || 3.5&nbsp;kg || 3.0–3.5

|-

| Adult male || || 8.0–8.5 White, Robertshaw, etc.) for ventilating each lung independently—this is useful during pulmonary and other thoracic operations.

Tracheostomy tube

Several types of tracheostomy tubes are available, depending on the requirements of the patient, including Shiley, Bivona (a silicon tube with metal rings that are good for airways with damage to the tracheal rings or otherwise not straight), and fenestrated.

Tracheal button

A tracheal button is generally used in people with severe obstructive sleep apnea, who often wear this device during waking hours and remove it while sleeping to ensure a patent airway and reduce the risk of asphyxiation. Since the tube does not extend far into the trachea, it is easy to breathe and speak with the device in place.

See also

  • Laryngeal tube
  • Tracheal intubation
  • Airway management

References

Further reading

  • Alt URL
  • ACLS algorithms with manual that includes further tracheal tube information.