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Over the last few years cuffed endotracheal tubes are being used more frequently in critically ill children. This episode looks at the possible reasons for this and reviews the evidence of whether this practise is safe.

References

1. Mostafa SM. Variation in subglottic size in children. Proc R Soc Med 1976:69:793-5.
2. Khine HH, Corddry DH, Kettrick RG et al. Comparison of cuffed and uncured endotracheal tubes in young children during general anesthesia. Anesthesiology 1997;86:627-31.
3. Gopalareddy V, He Z, Soundar S, et al. Assessment of the prevalence of microaspiration by gastric pepsin in the airway of ventilated children. Acta Paediatr 2008;97(1):55-60.
4. Litman RS, Weissend EE, Shibata D, Westesson PL. Developmental changes of laryngeal dimensions in unparalyzed, sedated children. Anesthesiology 2003;98(1):41-45.
5. Eckenhoff JE. Some anatomic considerations of the infant larynx influencing endotracheal anesthesia. Anesthesiology 1951;12(4):401-410.
6. Deakers TW, Reynolds G, Stretton M, Newth CJL. Cuffed endotracheal tubes in pediatric intensive care. J Pediatr 1994;125(1):57-62.
7. Dullenkopf A, Schmitz A, Gerber A, Weiss M. Tracheal sealing characteristics of pediatric cuffed tracheal tubes. Pediatric Anesthesia 2004;14:825-30.
8. Newth CJL, Rachman B, Patel N, Hammer J. The use of cuffed versus uncuffed endotracheal tubes in pediatric intensive care. J Pediatr 2004;144(3):333-337.
9. Taylor C, Subaiya L, Corsino D. Pediatric Cuffed Endotracheal Tubes: An Evolution of Care. The Ochsner Journal 2011;11:52–56.
10. Weiss M, Dullenkopf A, Gysin C, Dillier CM, Gerber AC. Shortcomings of cuffed paediatric tracheal tubes. Br J Anaesth 2004;92(1):78-88.
11. Dullenkopf A, Gerber AC, Weiss M. Fit and seal characteristics of a new paediatric tracheal tube with high volume-low pressure polyurethane cuff. Acta Anaesthesiol Scand 2005;49(2): 232-237.
12. Miller MA, Arndt J, Konkle MA et al. A polyurethane cuffed endotracheal tube is associated with decreased rates of ventilator-associated pneumonia. J Crit Care 2011;26(3):280-6.
13. Cuffed or uncuffed tracheal tubes during anaesthesia in infants and small children: time to put the eternal discussion to rest? Br J of Anaesth 2009;103(6):783-5.
14. Weiss M, Dullenkopf A, 1, Fischer JE et al. Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children. Br J of Anaesth 2009;103(6):867-73.