Evidence Based Use of Cuffed Endotracheal Tubes in Children

Historically, the use of cuffed endotracheal tubes (ETTs) was reserved for children aged 8 years or older to minimize the risks of postextubation laryngeal edema. However, since publication of a 1997 study, researchers have consistently presented evidence that appropriately used cuffed ETTs are as safe as uncuffed ETTs. Because of the advantages of cuffed ETTs in the perianesthesia setting, the transition to cuffed ETTs in children is now complete. However, risks related to using cuffed ETTs in young children increase when guidelines for safe and appropriate use are not followed. Perianesthesia practitioners caring for children must understand the implications related to ETT type, correct ETT sizing, and the monitoring and control of ETT cuff pressure. The purpose of this educational module is to present evidence-based guidelines for the appropriate use of cuffed ETTs in children less than 8 years of age in the perianesthesia setting.