Stabilisation of an Endotracheal Tube for the Adult Intensive Care ...
Stabilisation of an Endotracheal Tube for the Adult Intensive Care ...
Stabilisation of an Endotracheal Tube for the Adult Intensive Care ...
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how <strong>the</strong>se variables were defined leading to possible bias especially with respect to what<br />
‘thin adhesive tape’ actually was. A limited meta-<strong>an</strong>alysis by Gardner et al (2006) indicated<br />
that a commercial device might result in less lip excoriation (OR 0.22[0.10, 0.50, 95%CI])<br />
<strong>an</strong>d reduce <strong>the</strong> incidence <strong>of</strong> facial trauma (OR 0.40 [0.13, 1.22 95%CI]), however <strong>the</strong>se<br />
commercial products are not available in Australia.<br />
The external validation p<strong>an</strong>el (EVP) supported all <strong>of</strong> <strong>the</strong>se recommendations.<br />
Number<br />
3<br />
Statement:<br />
Patients with risk <strong>of</strong> raised intracr<strong>an</strong>ial pressure<br />
<strong>Endotracheal</strong> tube securing methods that may cause venous<br />
occlusion should be avoided <strong>for</strong> patients at risk <strong>of</strong> raised<br />
intracr<strong>an</strong>ial pressure.<br />
13<br />
Grade <strong>of</strong><br />
recommendation<br />
Consensus Opinion<br />
Most ETT stabilisation methods require <strong>the</strong> tapes or ties to go around <strong>the</strong> upper part <strong>of</strong> neck.<br />
There is however a <strong>the</strong>oretical risk that doing this may impair <strong>the</strong> venous drainage from <strong>the</strong><br />
head with a possible impact on intracr<strong>an</strong>ial pressure. The tracheal tube practices survey<br />
[Appendix 3] identified five units who varied <strong>the</strong>ir practices <strong>for</strong> neurological or neurosurgical<br />
patients <strong>for</strong> this reason. Whilst no published research data was found to support this, <strong>the</strong><br />
GDN members feel this is <strong>an</strong> import<strong>an</strong>t consideration <strong>for</strong> clinici<strong>an</strong>s when choosing <strong>the</strong> most<br />
appropriate method <strong>of</strong> ETT stabilisation.<br />
The EVP endorsed this recommendation.