Several types of research aimed to compare the applicability and success rates between cuffed and uncuffed endotracheal tubes in patients under the eight years of age. A study by Newton et al. (333) found no relationship between the success rate or risk of subglottic edema in children with cuffed or uncuffed endotracheal tubes. According to Cox (2005), although the study involved large quantities of samples, it was unfortunately limited due to its non-randomized, un-controlled and un-blinded experimental design. Nonetheless, the study provided basic evidence that the cuff in cuffed endotracheal tubes does not pose a suspected danger to the airway of children in the critical care setting.
Another study by Khine et al. (627) demonstrated a higher incidence of reintubation in uncuffed endotracheal tubes than in cuffed ones. Moreover, the group was also able to show that cuffed tubes were associated with a lesser probability of fresh gas flow needs compared to uncuffed tubes. Weiss et al. (“ Comparison of Cuffed and Uncuffed… ” 734) et al. , on the other hand, determined the differences in the length, position, placement and other relevant characteristics of both cuffed and uncuffed endotracheal tubes.
They found out that bend to tracheal tube tip distance was similar between same-size cuffed and uncuffed tubes, upper border to tracheal tube tip distance was shortest in some cuffed compared to uncuffed tubes, and that the tested tubes needed improved design as determined by the improper placement of cuffed tubes. According to Ho et al. , (169), one disadvantage of cuffed endotracheal tubes is the decreased margin of safety. According to their paper, the uncuffed tube’ s margin of safety is equal to the approximate length of the trachea whereas, in cuffed tubes, this margin is reduced of approximately 50% or more.
Proper insertion depth of endotracheal tubes in children is important to prevent inadvertent bronchial intubation, inflammation of the carina, and unintentional extubation.
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