Armored Endotracheal Tube

Solution

Reinforced endotracheal tubes, also known as "Tracheal Tubes with Spring," are designed to maintain airway patency during complex surgical procedures and prolonged ventilation. These tubes feature a spiral-wound metal wire embedded within the tube wall, providing enhanced resistance to kinking and ensuring consistent airflow even when the patient's position changes .

Constructed from soft, thermosensitive PVC, these tubes adapt to the patient's airway anatomy, minimizing trauma during intubation. They are available in both cuffed and uncuffed versions, with high-volume, low-pressure cuffs that provide an effective seal against the tracheal wall, reducing the risk of aspiration and allowing precise control of ventilation .

Additional features include radiopaque lines for X-ray visualization, depth markings for accurate placement, and universal 15 mm connectors compatible with standard breathing systems. These tubes are particularly indicated for neurosurgical and head and neck procedures, where maintaining airway integrity is critical despite patient positioning .

Features

1. Spiral-embedded wire reinforcement: The tube incorporates a stainless steel or nylon spiral (typically 0.3-0.5mm diameter) throughout its length, providing kink resistance while maintaining flexibility (bend radius <15mm without lumen collapse).

2. Thin-walled design: With wall thickness of 1.0-1.3mm (compared to 1.5-2.0mm in standard tubes), it offers a larger internal diameter relative to external size (e.g., 7.0mm ID with 9.4mm OD).

3. High-temperature tolerance: The medical-grade PVC or silicone material withstands temperatures from -20°C to 150°C, making it suitable for laser surgeries (laser penetration threshold >10W/mm²).

4. Low-pressure cuff system: The high-volume, low-pressure cuff (typically 25-30mm Hg) reduces tracheal mucosa ischemia risk while maintaining seal pressures of 18-22 cmH₂O.

5. Radiopaque markers: Contains barium sulfate stripes (3-5% concentration) for clear radiographic visualization, with marker lines spaced at 1cm intervals for depth measurement.

6. Flexible distal tip: The 45° angled Murphy eye (2.0-3.5mm diameter) reduces carinal trauma risk while maintaining patent airflow (>80% of main lumen cross-section).

Applications

Neurosurgical Procedures: These tubes are ideal for neurosurgeries where patient positioning may compromise airway integrity. The embedded spiral wire provides resistance to kinking, ensuring consistent airflow during complex head and neck surgeries.

Head and Neck Surgeries: In operations involving the head and neck, reinforced tubes offer flexibility and stability, reducing the risk of airway obstruction caused by external pressure or patient movement.

Fiberoptic Intubation: Their superior flexibility makes them advantageous for fiberoptic intubation via oral or nasal routes, facilitating easier navigation through the airway.

Emergency and Military Medicine: In emergency settings or military applications, these tubes are beneficial for managing difficult airways, especially when intubation must be performed in less-than-ideal conditions.

Prone Positioning Surgeries: For surgeries requiring the patient to be in a prone position, reinforced endotracheal tubes maintain their shape and prevent kinking, ensuring uninterrupted ventilation.

FAQ

Q: What is an Armored Endotracheal Tube?

A: An armored endotracheal tube is a flexible breathing tube reinforced with a spiral wire to prevent kinking, commonly used in surgeries requiring neck movement or prolonged intubation.

Q: When is an Armored Tube Preferred?

A: It's preferred in head & neck surgeries, prone positioning, or when patient movement risks tube compression.

Q: How Does the Spiral Reinforcement Help?

A: The embedded wire maintains patency under bending, reducing airway obstruction risks compared to standard tubes.

Q: Can Armored Tubes Be Cuffed?

A: Yes, most have high-volume, low-pressure cuffs to seal the trachea while minimizing tissue damage.

Q: Are There Disposable Armored Tubes?

A: Yes, single-use options exist, but reusable sterilizable versions are also available for cost efficiency.