endotracheal tube

気管チューブ。気管切開チューブ ETT

WordNet

1. ride or float on an inflated tube; "We tubed down the river on a hot summer day"
2. conduit consisting of a long hollow object (usually cylindrical) used to hold and conduct objects or liquids or gases (同)tubing
3. electronic device consisting of a system of electrodes arranged in an evacuated glass or metal envelope (同)vacuum_tube, thermionic vacuum tube, thermionic_tube, electron_tube, thermionic_valve
4. (anatomy) any hollow cylindrical body structure (同)tube-shaped structure
5. convey in a tube; "inside Paris, they used to tube mail"
6. place or enclose in a tube
7. provide with a tube or insert a tube into
8. the amount that a tub will hold; "a tub of water" (同)tubful
9. a large open vessel for holding or storing liquids (同)vat
10. of a tire; having an inner tube

PrepTutorEJDIC

1. (金属・ガラス・ゴムなどの)管,筒 / (絵の具・歯みがきなどの)チューブ / 《米》(列車・地下鉄の)トンネル / 《英》地下鉄(《米》subway) / (ラジオ・テレビなどの)真空管(vacuum tube) / (動植物の)管状器官
2. 『おけ』,たらい / 《話》'bath 2 / (また tubful)おけ1杯[の量](の…)《+of+名》 / 《話》のろくてぶかっこうな船;《俗》でぶ,太っちょ
3. 〈U〉管状の物 / 《集合的に》管類 / 〈C〉(ある長さの1本の)管

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/04/06 00:40:14」(JST)

wiki en

[Wiki en表示]

Tracheal tube
Intervention
Diagram of an endotracheal tube that has been inserted into the trachea: A - endotracheal tube (blue) B - cuff inflation tube with pilot balloon C - trachea D - esophagus
ICD-9-CM	96.04

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 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 2–3-inch-long (51–76 mm) 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 1 inch 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 cuffless plastic 'Ivory' endotracheal tubes, in conjunction with Magill's design later adding a cuff as manufacturing techniques became more viable, these were glued on by hand to make the famous Blue-line tube copied by many other manufacturers. Mallinckrodt GmBH developed the disposable endotracheal tube and produced a plethora of 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

Age	Weight	(Inner) diameter (mm)
Premie	3 kg	2.5–3.0
0–6 months	3.5 kg	3.0–3.5
6–12 months	7 kg	3.5–4.0
1–3 years	10–12 kg	4.0–4.5
4–7 years	16–18 kg	5.0–5.5
8–10 years	24–30 kg	5.5–6.5
Adult female		7.0-7.5
Adult male		8.0-9.0

A typical cuffed endotracheal tube, constructed of polyvinyl chloride.

A Carlens double-lumen endotracheal tube, commonly used for thoracic surgical operations such as VATS lobectomy.

Most endotracheal tubes today are constructed of polyvinyl chloride, but specialty tubes constructed of silicone rubber, latex rubber, or stainless steel are also widely available. Most tubes have an inflatable cuff to seal the trachea and bronchial tree against air leakage and aspiration of gastric contents, blood, secretions, and other fluids. Uncuffed tubes are also available, though their use is limited mostly to pediatric patients (in small children, the cricoid cartilage, the narrowest portion of the pediatric airway, often provides an adequate seal for mechanical ventilation).

Types of endotracheal tube include oral or nasal, cuffed or uncuffed, preformed (e.g. RAE (Ring, Adair, and Elwyn) tube), reinforced tubes, and double-lumen endobronchial tubes. For human use, tubes range in size from 2 to 10.5 mm in internal diameter (ID). The size is chosen based on the patient's body size, with the smaller sizes being used for pediatric and neonatal patients. Tubes larger than 6 mm ID usually have an inflatable cuff. Originally made from red rubber, most modern tubes are made from polyvinyl chloride. Those placed in a laser field may be flexometallic. Robertshaw (and others) developed double-lumen endo-bronchial tubes for thoracic surgery. These allow single-lung ventilation while the other lung is collapsed to make surgery easier. The deflated lung is re-inflated as surgery finishes to check for fistulas (tears). Another type of endotracheal tube has a small second lumen opening above the inflatable cuff, which can be used for suction of the nasopharngeal area and above the cuff to aid extubation (removal). This allows suctioning of secretions which sit above the cuff which helps reduce the risk of chest infections in long-term intubated patients.

The "armored" endotracheal tubes are cuffed, wire-reinforced, silicone rubber tubes which are quite flexible but yet difficult to compress or kink. This can make them useful for situations in which the trachea is anticipated to remain intubated for a prolonged duration, or if the neck is to remain flexed during surgery. Polyvinyl chloride tubes are relatively stiff in comparison. Preformed tubes (such as the oral and nasal RAE tubes, named after the inventors Ring, Adair and Elwyn) are also widely available for special applications. These may also be constructed of polyvinyl chloride or wire-reinforced silicone rubber. Other tubes (such as the Bivona Fome-Cuf tube) are designed specifically for use in laser surgery in and around the airway. Various types of double-lumen endotracheal (actually, endobronchial) tubes have been developed (Carlens, White, Robertshaw, etc.) for ventilating each lung independently—this is useful during pulmonary and other thoracic operations.

Tracheostomy tube

Further information: Tracheostomy

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

References

Further reading

• Brodsky, JB; Lemmens, JM (2003). "Left Double-Lumen Tubes: Clinical Experience With 1,170 Patients" (PDF). Journal of Cardiothoracic and Vascular Anesthesia 17 (3): 289–98. doi:10.1016/S1053-0770(03)00046-6. PMID 12827573. 

External links

• Resource explaining various types of endotracheal tubes
• ACLS algorithms with manual that includes further tracheal tube information.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 気管内チューブのマネージメントおよび合併症 endotracheal tube management and complications
• 2. 緊急挿管用の気管チューブイントロデューサ（ガムエラスティックブジ） endotracheal tube introducers gum elastic bougie for emergency intubation
• 3. 小児における緊急時の気管内挿管 emergency endotracheal intubation in children
• 4. Techniques and devices for airway management for anesthesia: Supraglottic devices (including laryngeal mask airways)
• 5. 成人における院内感染性／人工呼吸器関連／医療関連肺炎の危険因子および予防 risk factors and prevention of hospital acquired ventilator associated and healthcare associated pneumonia in adults

English Journal

• Tracheal intubation in patients with anticipated difficult airway using Boedeker intubation forceps and McGrath videolaryngoscope.

• Strøm C1, Barnung S1, Kristensen MS1, Bøttger M1, Tvede MF1, Rasmussen LS1.
• Acta anaesthesiologica Scandinavica.Acta Anaesthesiol Scand.2015 Oct;59(9):1154-60. doi: 10.1111/aas.12543. Epub 2015 May 16.
• BACKGROUND: Videolaryngoscopes with sharp angulated blades improve the view of the vocal cords but this does not necessarily result in higher success rates of intubation The aim of this study was to evaluate the efficacy of using Boedeker intubation forceps in conjunction with McGrath Series 5 Video
• PMID 25982220

• Comparison of the endotracheal tube cuff pressure between a tapered- versus a cylindrical-shaped cuff after changing from the supine to the lateral flank position.

• Kim HC1, Lee YH, Kim E, Oh EA, Jeon YT, Park HP.
• Canadian journal of anaesthesia = Journal canadien d'anesthesie.Can J Anaesth.2015 Oct;62(10):1063-1070. Epub 2015 Apr 17.
• PURPOSE: Positional change can displace an endotracheal tube (ETT) and change the ETT cuff pressure in a tracheally intubated patient. Endotracheal tubes with different cuff shapes may lead to different cuff pressures after positional change. We hypothesized that the intracuff pressure in the TaperG
• PMID 25894912

• The Tools of the Trade - Uses of Flexible Bronchoscopy.

• Singh V1, Singhal KK2.
• Indian journal of pediatrics.Indian J Pediatr.2015 Oct;82(10):932-7. doi: 10.1007/s12098-015-1869-1. Epub 2015 Aug 20.
• Bronchoscopes have markedly improved the diagnosis as well as therapy in pediatric pulmonary disorders. Two types of bronchoscopes are available; flexible and rigid, with their own advantages and disadvantages. Depending on the clinical need and availability of skills, choice is made between the two
• PMID 26286177

Japanese Journal

• Mechanical characteristics of bending in endotracheal tubes

• Daigo Erina,Sakuma Yasushi,Kato Yasuhiko,Kotani Junichiro
• Journal of Osaka Dental University 45(2), 237-240, 2011-10
• … The ideal endotracheal tube passes easily along the respiratory tract and is resistant to losing its shape. … Using Parker Flex-Tip^[○!R] and Sheridan/CF^[○!R] oral endotracheal tubes, we investigated the force required to bend the tube in relation to the thickness of the tube wall. … The thickness of the tube wall was also significantly thinner in the Parker Flex-Tip^[○!R]. …
• NAID 110008761449

• Provision of stable lung isolation in an unstable patient : an endobronchial blocker through the Murphy eye of the in situ endotracheal tube

• HO Anthony M.-H.,WAN Innes Y. P.,WONG Randolph H. L.,NG Calvin S. H.,NG Siu K.
• Journal of anesthesia 25(3), 454-456, 2011-06-20
• NAID 10029023360

Related Links

• Endotracheal intubation: MedlinePlus Medical Encyclopedia

Endotracheal intubation is a medical procedure in which a tube is placed into the windpipe (trachea) through the mouth or nose. In most emergency situations it is placed through the mouth. Whether you are awake ...

• Endotracheal tube | definition of endotracheal tube by Medical ...

endotracheal [en″do-tra´ke-al] within the trachea. endotracheal tube an airway catheter inserted in the trachea during endotracheal intubation to assure patency of the upper airway by allowing for removal of secretions and maintenance ...

Related Pictures

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★リンクテーブル★

リンク元	「気管チューブ」「気管内チューブ」
拡張検索	「Oxford endotracheal tube」
関連記事	「tube」「endotracheal」

「気管チューブ」

　　[★]

英

tracheal tube

関

気管内チューブ endotracheal tube、気管カニューレ

麻酔科研修チェックノート 改訂第3版 p.111

5歳以下はカフなし

• サイズ：

成人

男性 8.0, 8.5, 9.0mmI.D.　　女性：7.0, 7.5, 8.0mmI.D.

小児(2-6歳)

4.0+(年齢/4) mmI.D.

新生児

(体重1500g以下)2.5mmI.D.

(体重1500g以上)3.0mmI.D.

• 深さ(門歯から)

成人

(男性)23cm、女性(21cm)

小児(2-6歳)

12+(年齢/2) cm

新生児

(体重1000g)7cm

(体重2000g)8cm

(体重3000g)9cm

ECCハンドブック2010 p.90

チューブ内径

• 2～10歳の小児

カフ無し

= (年齢 ÷ 4 ) + 4

カフ有り

= (年齢 ÷ 4 ) + 3.5

カフ圧

• 20-25cmH2O未満であること

チューブ深さ

• 2歳以上の小児

= (年齢 ÷ 2) + 12 あるいは = チューブ内径 x 3

「気管内チューブ」

　　[★]

英

endotracheal tube

同

気管チューブ tracheal tube

「Oxford endotracheal tube」

　　[★] オックスフォード気管チューブ

「tube」

　　[★]

• n.

• 管、チューブ

関

canal、duct、ductal、ductus、meatus、pipe、tubal、vas

　 　 　 　 　 　 　 　

「endotracheal」

　　[★]

• 気管内の

関

intratracheal、intratracheally