Selection of appropriate endotracheal tube size using thoracic radiography in Beagle dogs

Chi Won Shin, Won gyun Son, Min Jang, Hyunseok Kim, Hyungjoo Han, Jeesoo Cha, Inhyung Lee

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Objective: To determine the optimal endotracheal tube size in Beagle dogs using thoracic radiography. Study design: Prospective, randomized, crossover experimental study. Animals: A total of eight healthy adult Beagle dogs. Methods: Lateral thoracic radiographs were used to measure the internal tracheal diameter at the thoracic inlet. This measurement was multiplied by 60, 70 and 80% to determine the outer diameter of the endotracheal tube for each dog. In each treatment, medetomidine (5 μg kg−1) was administered intravenously (IV) for premedication. Anesthesia was induced with alfaxalone (2 mg kg−1) IV and maintained with isoflurane. After induction of anesthesia, the resistance to passage of the endotracheal tube through the trachea was scored by a single anesthesiologist. Air leak pressures (Pleak) were measured at intracuff pressures (Pcuff) of 20 and 25 mmHg (27 and 34 cmH2O). The results were analyzed using Friedman tests and repeated measures ANOVA. Results: There were statistically significant increases in resistance as the endotracheal tube size increased (p = 0.003). When Pcuff was 20 mmHg, mean Pleak for the 60, 70 and 80% treatments were 9.7 ± 6.7, 16.2 ± 4.2 and 17.4 ± 3.9 cmH2O, respectively, but no significant differences were found. When Pcuff was 25 mmHg, mean Pleak for the 60, 70 and 80% treatments were 10.6 ± 8.5, 19.7 ± 4.9 and 20.8 ± 3.6 cmH2O, respectively, and statistically significant increases were found between treatments 60 and 70% (p = 0.011) and between treatments 60 and 80% (p = 0.020). Three dogs in the 80% treatment had bloody mucus on the endotracheal tube cuff after extubation. Conclusions and clinical relevance: Results based on resistance to insertion of the endotracheal tube and the ability to achieve an air-tight seal suggest that an appropriately sized endotracheal tube for Beagle dogs is 70% of the internal tracheal diameter measured on thoracic radiography.

Original languageEnglish
Pages (from-to)13-21
Number of pages9
JournalVeterinary Anaesthesia and Analgesia
Volume45
Issue number1
DOIs
StatePublished - Jan 2018

Keywords

  • air leak pressure
  • dog
  • endotracheal tube size
  • resistance
  • thoracic radiography

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