Endotracheal Intubation

Vygon Vet endotracheal tubes are manufactured in transparent PVC which allows visual inspection for lumen patency prior to use. Cuffed versions feature high volume, low pressure cuffs to minimise tracheal trauma whilst maintaining an effective airway seal. The proportion of airway occupied by a cuff becomes more significant in the very small patient, and cuffed tubes need to be slightly smaller for the given patient airway size. Uncuffed versions are available that are suitable for cats, small dogs and rabbits. Endotracheal tubes are sized by their internal diameter and this represents the effective upper airway diameter available after intubation.

• Sizing - Select a tube which is as large as possible to maximise patient airway diameter, ensuring it is not so large that it may cause airway trauma, aim for a "snug fit". Airway size does not correlate exactly with weight and varies with breed and obesity. In cats, effective laryngeal relaxation is important if a maximally-sized tube is to be inserted. Apply local anaesthetic and allow adequate time for onset of action before intubating.

 • Length - Endotracheal tubes should be no longer than required and should fit as shown in the diagram. The connector should be visible to allow access and monitoring for disconnection. Airway resistance and dead space increase dramatically if a tube that is too long is used. This is particularly relevant in small animals such as cats. Long tubes can also result in single lung ventilation. It is important that our smaller diameter tubes are cut to length before use.

• Cuffs - The use of a cuff ensures an effective airway seal and reduces the risk of fluids and debris entering the airway. Inflate cuffs to the minimum pressure required to seal the airway, over-inflation can cause serious trauma. Monitor inflation throughout intubation in case of slow leaks. Cuffs should be fully deflated before extubation.

• Security - Use a non-stretch bandage to securely tie the tube after placement, tying around the tube behind the canine teeth and then behind the animal's ears, as shown in the diagram.

• Patency - It is vital to check tubes for patency before and during use. Secretions or other fluids must be removed promptly. The Vygon Vet range of tracheal suction catheters is ideal for removal of any fluid accumulation within endotracheal tubes.

Endotracheal products from Vygon Vet:
Endotracheal tubes

© Vygon (UK) Ltd 2009