Extubation force: tape versus endotracheal tube holders.

Abstract

Tape is the standard method for securing endotracheal tubes to prevent extubation. This study examines the force required to extubate endotracheal tubes from cadavers with either tape or one of 4 commercially available endotracheal tube holders. Newly deceased, unembalmed cadavers were intubated with standard tracheal intubation techniques. The endotracheal tube was secured with either tape or one of 4 commercially available endotracheal tube holders. The endotracheal tube was then connected to a force-measuring device and pulled until the cuff was removed from the trachea. The largest force recorded on the device was then marked as the "extubation force" for that trial. When tape was used to secure the endotracheal tube, it required a significantly larger force to extubate than 3 of 4 off-the-shelf endotracheal tube holders. Only the Thomas Tube Holder secured the endotracheal tube better than tape. Although the Thomas Tube Holder had the greatest holding force in this study, tape was shown to be the least expensive and outperformed 3 other commercially available devices used to secure endotracheal tubes.