Background: Surveys of pediatric endotracheal tube (ETT) management\npreviously reported that specialists in pediatric anesthesia and intensive\ncare medicine preferred to use uncuffed ETTs for children younger than 8\nto 10 years of age. The aim of this study was to reveal the most recent attitudes\nand clinical practices of pediatric ETT management in Japan.\nMethods: The attitudes and clinical practices of pediatric ETT management\nwere investigated using the data sheets of each institution and each patient.\nThe data sheets contained information on patient characteristics and\ntype of hospital, surgical procedures, devices used for intubation, and ETT\ninformation including types, size, depth, intracuff pressure (ICP), interval\nof ICP measurement, laryngeal packing, ETT exchange, airway complications,\nand reintubations.Results: The response rate of this survey was\n66.7%. More than half of children older than 2 years of age were intubated\nwith cuffed ETTs; 83.5% of cuffed ETTs were used with the cuffs inflated,\nand ICP was measured in 80.7% of cuffed ETTs. More than half of ICP\nmeasurements were only taken at the time of intubation. Post-extubation\nstridor was rarely observed in cuffed (0.4%) or uncuffed ETTs (1.2%). The\npediatric ETT management questionnaire revealed age-based size selection,\ndifferences in pressure of air leakage between cuffed (15 - 20 cmH2O)\nand uncuffed ETTs (20 - 30 cmH2O) of different sizes, the depth-marking\nmethod of insertion length. Continuous measurement of ICP was not\ncommon. Conclusion: This study revealed widespread use of cuffed ETTs in\nchildren older than 2 years of age, rarely occurrence of post-extubation\nstridor, inflation of cuffs, and practice of ICP measurement.
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