Smaller endotracheal tube sizes are not associated with poorer survival or recovery among critically ill patients, despite differences in length of intubation, according to a cohort study published in JAMA Otolaryngology—Head & Neck Surgery. Brandon I. Esianor, MD, and colleagues analyzed data from adults who received endotracheal intubation in the ED or ICU and mechanical ventilation for at least 12 hours from June-November 2020 at a single academic medical center. The investigators categorized patients (N=814) into three endotracheal tube groups: small for height (N=182), appropriate for height (N=408), and large for height (N=224). They observed no significant difference in 30-day, all-cause, in-hospital survival between groups for small versus appropriate tubes (HR, 1.1; 95% CI, 0.7-1.7) and for large versus appropriate tubes (HR, 1.1; 95% CI, 0.7-1.6). Patients with small-for-height endotracheal tubes had increased intubation times compared with patients with appropriate-for-height tubes (mean difference, 32.5 hours). The findings support future prospective exploration of the association of smaller endotracheal tube sizes with recovery from critical illness,” according to Dr. Esianor and colleagues.
