Cuffed endotracheal tubes for neonates and young infants

a comprehensive review

Thomas, Rebecca
Rao, Shripada
Minutillo, Corrado

¹Neonatal Clinical Care Unit, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
²Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
³Neonatal Clinical Care Unit, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia

Dr Rebecca Thomas, Princess Margaret Hospital for Children, Neonatal Clinical Care Unit, Roberts Road, Subiaco, WA 6008, Australia; [email protected]

Received June 24, 2015

Received in revised form August 24, 2015

Accepted September 17, 2015

Archives of Disease in Childhood, Fetal & Neonatal Edition 101(2):p F168-F174, March 2016. | DOI: 10.1136/archdischild-2015-309240

Traditionally, uncuffed endotracheal tubes (ETTs) have been used for artificial ventilation of infants and children. More recently, newer designed high-volume low-pressure (HVLP) cuffed ETTs are being used with increasing frequency in infants from birth. Considering that many paediatric anaesthetists and intensivists are already using cuffed ETTs in infants >3 kg from birth, should neonatologists be doing the same? This review examines the reasons behind the traditional use of uncuffed ETTs and the problems associated with their use; newer HVLP cuffed ETTs and what they can potentially offer neonates; and reviews evidence from studies comparing the use of cuffed and uncuffed ETTs in neonates and small infants.