Types and selection of disposable tracheal intubation

Endotracheal Tube (Tracheal tube) refers to the technique of inserting a special endotracheal tube into the trachea through the glottis, called tracheal intubation. This technology can provide conditions for unobstructed airway, ventilation and oxygen supply, airway suction and prevention of aspiration.

1. Conventional tracheal intubation

More common, the intubation tube has good stability, is not prone to prolapse, and the fixed method is convenient for oral care. However, the ordinary tracheal intubation tube is mainly made of PVC material. During use, due to problems such as the intubation material, the patient will experience mucosal damage and cause bleeding symptoms, which will have a greater impact on the patient's normal treatment.

2. Reinforced tracheal intubation

Reinforced tracheal intubation undoubtedly has huge advantages over ordinary tracheal intubation in terms of material and composition. The reinforced endotracheal tube is also called a spring tube.

The main material is special soft resin and the wall has spiral steel wire, which greatly improves the flexibility of the tube body. Generally, the tube core is coated with lubricating paraffin oil during the use of the reinforced tracheal intubation. , Can make the intubation more smooth, the intubation time and success rate have certain advantages compared with the ordinary tracheal intubation.

In addition, the tip of the reinforced tracheal intubation is softer and can change with the shape of the upper airway. The fit is better, the friction with the mucosal tissue is reduced, the damage is small, and the occurrence of complications can be effectively controlled.

Disposable endotracheal tube

3. Flushable tracheal intubation

In mechanically ventilated patients, due to the weakened or disappeared swallowing reflex, cough reflex and cilia of the lower respiratory tract, oropharyngeal secretions and colonizing bacteria tend to accumulate on the intubation balloon carver, forming a "mucus paste" in this area, which becomes a storage of bacteria Library. Therefore, to effectively prevent the occurrence of VAP, it is necessary to promptly and effectively remove secretions above the airbag of the tracheal intubation.

Flushing tracheal intubation, so that the secretions and colonizing bacteria accumulated in the subglottis can be sucked out with the flushing fluid, directly reducing the leakage of secretions from the mouth, nasopharynx and lower respiratory tract and the migration of colonizing bacteria, while ordinary tracheal intubation can not affect the air sac Washing the upper retentate helps reduce the incidence of postoperative lung complications in the hospital and delays the occurrence of ventilator-related pneumonia.

Flushable tracheal intubation

4. Single-lumen bronchial intubation

It is a single-lumen cannula placed in the bronchus. The artificial airway that implements lung isolation and one-lung ventilation is collectively referred to as endobronchial intubation. One-lung ventilation refers to the selective detection of lung ventilation during thoracotomy, and the unventilated lung of the affected lung collapses. It is characterized by slender body and short cuff. In order to ensure the ventilation of the upper lobe of the right lung, the anterior cuff of the right bronchial intubation is divided into two sections, with a side opening in the middle corresponding to the opening of the bronchus of the right upper lobe.

5. Double-lumen bronchial intubation

There are many types of dual-lumen bronchial intubation widely used in clinical single lung ventilation, including Carlen, White and Robertshaw. The design principle is basically the same: one tube with two cavities, two sections with two openings, one opening is located at the distal end of the cannula, the other opening is located at the main bronchus, and air bags are installed in the trachea and the main bronchus respectively.

Double lumen bronchial intubation

However, double-lumen endotracheal intubation has higher requirements for the surgeon. Due to the anatomical structure of the right main bronchus, it is difficult to ensure the correct position of the intubation.