Quels sont les tubes trachéaux couramment utilisés en pratique clinique ?

1. Conventional tracheal tube

It has good stability and is not prone to prolapse. At the same time, the fixation method is convenient for oral care, which is more common in clinical practice. Mainly made of PVC material. During use, due to tube material and other problems, 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 tube

The reinforced tracheal tube has a huge advantage over the conventional tracheal tube in terms of material and composition. The reinforced tracheal tube is also called a spring tube. Its main material is a special soft resin and the wall has a spiral steel wire, which greatly improves the flexibility of the tube. It is generally used during the use of the reinforced tracheal tube Lubricating paraffin oil is applied to the tube core, which can make the intubation more smooth, and the intubation time and success rate have certain advantages compared with ordinary tracheal tubes. In addition, the tip of the reinforced tracheal tube has a softer texture, which can change with the shape of the upper airway, resulting in a better anastomosis, reducing friction with mucosal tissues, and less damage, which can effectively control complications.

3. Flushable tracheal tube

In mechanically ventilated patients, due to the weakened or disappeared swallowing reflex, cough reflex and cilia movement of the lower respiratory tract, oropharyngeal secretions and colonizing bacteria tend to accumulate on the tube balloon, forming a "mucus paste" in this area, which becomes a reservoir of bacteria. Therefore, to effectively prevent this phenomenon, it is necessary to promptly and effectively remove the secretions above the tracheal tube balloon. The flushing tracheal tube allows the secretions and colonizing bacteria accumulated in the subglottis to 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. The conventional tracheal tube cannot flush the remaining material above the balloon, which helps to reduce the incidence of postoperative pulmonary complications in the hospital and delay the occurrence of ventilator-associated pneumonia.

4. Single-lumen tracheal tube

It is a single-lumen tube placed in the bronchus. The artificial airway that implements lung isolation and one-lung ventilation is collectively called endotracheal tube. One-lung ventilation refers to the selective detection of lung ventilation during thoracotomy, and the unventilated lung of the affected side lung collapses. It is characterized by slender tube body and short cuff. In order to ensure the ventilation of the upper lobe of the right lung, the front cuff of the right bronchial tube 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 tracheal tube

There are many varieties of dual-lumen tracheal tubes widely used in clinical single-lung ventilation. The design principle is basically the same: one tube with two lumens, two sections with two openings, one opening is located at the distal end of the tube, the other opening is located at the main bronchus, and air balloons are installed in the trachea and the main bronchus respectively. However, the double-lumen endotracheal tube intubation has higher requirements for the surgeon. Due to the characteristics of the anatomical structure of the right main bronchus, it is difficult to ensure the correct position of the tube.

6. Pediatric tracheal tube

The pediatric tracheal tube is marked with a single or double black circle at 2cm and 3cm from the front end. The purpose is to guide the length of the tube into the trachea to prevent the insertion from being too deep. Some children's duct walls are also coated with a longitudinal black line that can be radiated, which can be visualized under X-rays to understand the position of the duct in the trachea. Children under 5 years old need to use a cuffless tracheal tube to increase the safety of use. This is related to the cricoid cartilage at the narrowed part of the airway in children.