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Endotracheal tubes

Created: 16/2/2005
Updated: 6/12/2017

Red rubber tracheal tubes have been replaced by sterile disposable PVC tubes. The modern ETT carries the following information:

Internal diameter (mm)

IT or Z79-IT indicates that the tube has been implant tested in rabbit muscle for tissue compatibility. This is in accordance with the American National Standards Committee.

 Distance from the tip of the tube is marked along its length.


 Radio-opaque line (for X-ray detection).


 Murphy eye, allows ventilation in the event of obstruction of the end of the tube.

Cuff with a pilot balloon. This cuff seals the trachea to avoid gas leaks or contamination. Prolonged pressure from the cuff may cause mucosal ischaemia. Uncuffed tubes should be used in Paediatric anaesthesia.



Other examples of endotracheal tubes (click for larger images)

Nasal endotracheal tube

RAE tube

 Reinforced endotracheal tubes:

These resemble standard endotracheal tubes, but also contain a spiral of metal or nylon in the tube wall. This is particularly useful where kinking of the tube may occur, e.g. during neurosurgery, maxillo-facial surgery and in patients in the prone position. They cannot be cut to size, hence one should be meticulous about the final position of the tube.



[i] Intubation guide marks for correct tube placement, a clinical study. Mehta, S. Anaesthesia 1991; 46: 306-8 (55/5/28)

[ii] Rationalization of the selection of tracheal tubes. Chandler, M, Crawley, BE. Br J Anaesth 1986; 58: 111-6 (55/1/2)

[iii] The effects of cuffed endotracheal tubes on the tracheal wall. Mathias DB, Wedley JR. Br J Anaesth 1974; 46: 849-52 (11/2/44)

[iv] Prolonged endotracheal intubation in infants and children. Allen TH, Steven IM. Br J Anaesth 1965; 37: 566-73

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