Comparison of the effectiveness of two types of commercial endotracheal tube holders, with the conventional method in a manikin model

Authors

1 Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Al-Zahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Endotracheal intubation is employed to create a safe airway in patients requiring mechanical ventilation. The relatively high prevalence rate of unplanned displacement of the endotracheal tube (ETT) can be associated with serious complications. This study was conducted to evaluate the effectiveness of a newly designed tube holder in Iran (Irafit), the Thomas ETT holder and the traditional method using adhesive tape.
Materials and Methods: The present manikin-based study was performed on the human mannequin. For this purpose, the mannequin was first subjected to oral intubation by a skilled emergency medicine specialist. Then, three methods of adhesive tape, Irafit-ETT holder, and Thomas-ETT holder were used. The mean of displacement in width of the mouth, length of the ETT, and depth as well as ETT removal was recorded.
Results: The results of the present study revealed that the displacement in depth was significantly less in the Irafit-ETT holder as compared with the other two groups following the application of a tug (P < 0.001). The displacement in the length of the ETT with and without the application of a tug was significantly less in the Irafit-ETT holder and Thomas-ETT holder groups as compared with the adhesive tape group (P < 0.001).
Conclusion: According to the results of the present study, it can be stated that both ETT holder devices (Thomas vs. Irafit) were not distinct in terms of displacements in length and width; however, the Iranian model was more successful in minimizing the displacement in depth.

Keywords

1.
Danielis M, Chiaruttini S, Palese A. Unplanned extubations in an intensive care unit: Findings from a critical incident technique. Intensive Crit Care Nurs 2018;47:69-77.  Back to cited text no. 1
    
2.
Hyzy RC, Manaker S, Finlay G. Complications of the endotracheal tube following initial placement: Prevention and management in adult intensive care unit patients. Crit Care Med 2017;24:25.  Back to cited text no. 2
    
3.
Cosentino C, Fama M, Foà C, Bromuri G, Giannini S, Saraceno M, et al. Unplanned extubations in Intensive Care Unit: Evidences for risk factors. A literature review. Acta Biomed 2017;88:55-65.  Back to cited text no. 3
    
4.
Hardcastle T, Köhne KM. Unplanned extubations in a level one trauma ICU. S Afr J Anaesth Analg 2018;24:103-8.  Back to cited text no. 4
    
5.
Murdoch E, Holdgate A. A comparison of tape-tying versus a tube-holding device for securing endotracheal tubes in adults. Anaesth Intensive Care 2007;35:730-5.  Back to cited text no. 5
    
6.
Vaz F. Airway management. In: ENT: An Introduction and Practical Guide. CRC Press: Parent company: Taylor & Francis, (United States); 2017. p. 151-3.  Back to cited text no. 6
    
7.
Christie JM, Dethlefsen M, Cane RD. Unplanned endotracheal extubation in the intensive care unit. J Clin Anesth 1996;8:289-93.  Back to cited text no. 7
    
8.
Buckley JC, Brown AP, Shin JS, Rogers KM, Hoftman NN. A comparison of the Haider Tube-Guard® endotracheal tube holder versus adhesive tape to determine if this novel device can reduce endotracheal tube movement and prevent unplanned extubation. Anesth Analg 2016;122:1439-43.  Back to cited text no. 8
    
9.
Suttapanit K, Yuksen C, Aramvanitch K, Meemongkol T, Chandech A, Songkathee B, et al. Comparison of the effectiveness of endotracheal tube holder with the conventional method in a manikin model. Turk J Emerg Med 2020;20:175-9.  Back to cited text no. 9
  [Full text]  
10.
Gardner A, Hughes D, Cook R, Henson R, Osborne S, Gardner G. Best practice in stabilisation of oral endotracheal tubes: A systematic review. Aust Crit Care 2005;18:158, 160-5.  Back to cited text no. 10
    
11.
Mussa CC, Meksraityte E, Li J, Gulczynski B, Liu J, Kuruc A. Factors associated with endotracheal tube related pressure injury. SM J Nurs 2018;4:1-6.  Back to cited text no. 11
    
12.
Byun SH, Kang SH, Kim JH, Ryu T, Ki BJ, Jung JY. Comparison of a tube-holder (Rescuefix) versus tape-tying for minimizing double-lumen tube displacement during lateral positioning in thoracic surgery. Medicine 2017;95:31.  Back to cited text no. 12
    
13.
Tasota FJ, Hoffman LA, Zullo TG, Jamison G. Evaluation of two methods used to stabilize oral endotracheal tubes. Heart Lung 1987;16:140-6.  Back to cited text no. 13
    
14.
Mohammed HM, Hassan MS. Endotracheal tube securements: Effectiveness of three techniques among orally intubated patients. Egypt J Chest Dis Tuberc 2018;64:183-96.  Back to cited text no. 14
    
15.
Levy H, Griego L. A comparative study of oral endotracheal tube securing methods. Chest 1993;104:1537-40.  Back to cited text no. 15
    
16.
Luria S, Vidan A, Nahtomi O, Khanin A, Alcalay M. Proposed technique for evaluation of endotracheal tube fixation and comparison of four fixation methods. Mil Med 2001;166:82-4.  Back to cited text no. 16