Peer-reviewed veterinary case report
Endotracheal tube narrowing and misplacement in anesthetized cats
By Lloyd, Ffion et al.·Published in Veterinary anaesthesia and analgesia·2023·Small Animal Hospital, United Kingdom·View original on PubMed →
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Original publication title: Retrospective computed tomography analysis of endotracheal tube constriction and mispositioning in cats and dogs.
- Species:
- dog
Plain-English summary
A study looked at 146 cats and 670 dogs that were under anesthesia to see how often their endotracheal tubes (ETTs) were either constricted or improperly placed. It found that about 23% of the tubes were constricted, which can make it harder for the pet to breathe. The most common reason for this constriction was the use of a mouth gag during radiotherapy. The researchers recommend that veterinarians check the ETT for any issues, especially in smaller pets and brachycephalic breeds (like Bulldogs and Pugs) that are more likely to have problems with tube placement.
People also search for: dog anesthesia breathing problems · cat endotracheal tube issues · brachycephalic dog anesthesia risks
Abstract
OBJECTIVE: To discover the prevalence of endotracheal tube (ETT) constriction and rostral and caudal mispositioning in anaesthetized cats and dogs, and to identify associated risk factors. STUDY DESIGN: Retrospective analysis. ANIMALS: A total of 146 cats and 670 dogs. METHODS: Computed tomography images of the head/neck/thorax from orotracheally intubated cats and dogs were visually assessed for constriction or mispositioning of the ETT. If constriction was present, measurements of the cross-sectional area (CSA) of the ETT lumen at constricted and un-constricted locations were compared. Location and cause of constriction were noted and the expected increase in resistance to gas flow was calculated. Animal information was collected from clinical records. Normality of continuous variables was assessed via the Shapiro-Wilk test. Chi-square tests examined associations between variables. Kendall's tau-b test was performed between measured ETT size and degree of constriction. RESULTS: The ETT extended rostrally beyond incisors in 52% of cases; the connector was within the oral cavity in 19% of cases. The ETT extended beyond the first rib in 25.5% of cases. The prevalence of ETT constriction was 22.7%. Median reduction in CSA was 7.68% (0.14-64.19%). Median increase in resistance assuming laminar and turbulent flow was 16.5% (0.3-680%) and 21% (0.3-1200%), respectively. The most common cause of constriction was the presence of a radiotherapy mouth gag. Significant associations existed between presence of constriction and rostral mispositioning, and caudal mispositioning and extreme brachycephaly. Increased severity of constriction was more likely in smaller ETT. CONCLUSIONS AND CLINICAL RELEVANCE: Constriction and mispositioning of ETT occurred very commonly in this population. Checking the ETT within the oral cavity for constriction and mispositioning is recommended. Radiotherapy mouth gags increase the risk of ETT compression. Smaller ETT are at greater risk of severe constriction. Brachycephalic dogs are at particular risk of caudal mispositioning.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37735027/