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pearl
1
Cuffed paediatric endotracheal tubes improve ventilation and reduce peri-operative respiratory complications in children undergoing elective general anaesthesia.
Chambers NA, Ramgolam A, Sommerfield D et al. Cuffed vs. uncuffed tracheal tubes in children: a randomised controlled trial comparing leak, tidal volume and complications. Anaesthesia. 2018 Feb 1; 73 (2): 160-168.
  Daniel Jolley
pearl
1
Positive pressure ventilation with an endotracheal tube shifts regional lung ventilation ventrally.
Lumb AB, Savic L, Horsford MR et al. Effects of tracheal intubation and tracheal tube position on regional lung ventilation: an observational study. Anaesthesia. 2020 Mar 1; 75 (3): 359-365.
  Daniel Jolley
pearl
1
Perioperative intravenous lidocaine prevents intubation, extubation and opioid-induced cough in adults and children in a dose-dependent fashion.
Clivio S, Putzu A, Tramèr MR. Intravenous Lidocaine for the Prevention of Cough: Systematic Review and Meta-analysis of Randomized Controlled Trials. Anesth. Analg. 2019 Nov 1; 129 (5): 1249-1255.
  Daniel Jolley
pearl
1
For routine anaesthesia in ASA 1 & 2 patients a 6.0-7.0 mm ETT is probably the best balance between ventilation needs and airway trauma.
Karmali S Rose P. Tracheal tube size in adults undergoing elective surgery - a narrative review. Anaesthesia. 2020 Nov 1; 75 (11): 1529-1539.
  Daniel Jolley
pearl
1
Intravenous lidocaine/lignocaine reduces post-extubation cough and sore throat.
Yang SS, Wang NN, Postonogova T et al. Intravenous lidocaine to prevent postoperative airway complications in adults: a systematic review and meta-analysis. Br J Anaesth. 2020 Mar 1; 124 (3): 314-323.
  Daniel Jolley
pearl
1
Minor airway trauma is common even after short-duration elective endotracheal intubation.
Avrahami E, Frishman E, Spierer I et al. CT of minor intubation trauma with clinical correlations. Eur J Radiol. 1995 May 1; 20 (1): 68-71.
  Daniel Jolley
pearl
1
There is significant individual variation in tracheal and cricoid dimensions, although mean dimensions are smaller in women than men.
Randestad A, Lindholm CE, Fabian P. Dimensions of the cricoid cartilage and the trachea. Laryngoscope. 2000 Nov 1; 110 (11): 1957-61.
  Daniel Jolley
comment
0
While the reliability of this simple formula is interesting, the authors note the wide variability in nasal tubes from different manufacturers, particularly in length and guide markings for the same-sized tube. Thus although interesting, there is questionable utility in this formula.
Correct ETT depth is probably better determined clinically: visually observing the cuff pass the laryngeal inlet and cords, and auscultation to exclude endobronchial intubation. At best, a predictive-depth formula is a useful sanity-check.
Massoth C, Schülke C, Köppe J et al. Nasolaryngeal Distances in the Adult Population and an Evaluation of Commercially Available Nasotracheal Tubes. Anesth. Analg. 2020 Apr 1; 130 (4): 1018-1025.
  Daniel Jolley
pearl
1
Most parkour injuries occur on landing or striking objects, and involve the extremities.
Rossheim ME Stephenson CJ. Parkour injuries presenting to United States emergency departments, 2009-2015. Am J Emerg Med. 2017 Oct 1; 35 (10): 1503-1505.
  Daniel Jolley
pearl
1
Deep neuromuscular block did not improve quality of recovery after laparoscopic surgery.
Boggett S, Chahal R, Griffiths J et al. A randomised controlled trial comparing deep neuromuscular blockade reversed with sugammadex with moderate neuromuscular block reversed with neostigmine. Anaesthesia. 2020 Sep 1; 75 (9): 1153-1163.
  Daniel Jolley