title: Evaluation of endotracheal tube safety for CO2 laser resurfacing.
abstract: OBJECTIVE
  The new generation carbon dioxide lasers have become popular as a result of their ease of use and consistent results. Their use is becoming widespread with both the experienced laser surgery clinician and those just venturing into the realm of laser resurfacing. The purpose of this study was to evaluate the safety of the common PVC endotracheal and one designed for laser procedures if contacted by the CO2 laser during resurfacing. In addition, the cost and efficacy of a simple covering to the PVC tube was assessed.
  
  
  METHODS
  Endotracheal tubes were subjected to multiple passes of the Coherent Ultrapulse laser system while recording tube effect and intraluminal temperature.
  
  
  METHODS
  With the highest energy densities used in our practice, multiple passes were made over both PVC and Xomed Laser-Shield II endotracheal tubes with 100% intraluminal oxygen. Thermocouplers recorded both inflow and outflow temperatures. The procedure was repeated with PVC endotracheal tubes covered with saline-soaked sponges held in place with netting.
  
  
  RESULTS
  Charring of the PVC tube occurred after 1 pass, and intraluminal smoke was present after 21.6 passes. The Laser-Shield II and the wrapped PVC tube did not show significant charring or tube lumen breach after up to 200 passes. The prepared PVC tube was $105.14 less than the commercial tube.
  
  
  CONCLUSIONS
  Our method of PVC endotracheal tube preparation provides a safe, inexpensive, reliable airway during CO2 laser resurfacing.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of South Florida, Tampa, Florida 33612, U.S.A.
authors.forename: John C
authors.initials: JC
authors.lastname: Ferguson
authors.forename: Rebecca T
authors.initials: RT
authors.lastname: Carr
authors.forename: Edward W
authors.initials: EW
authors.lastname: Chang
authors.forename: Edward H
authors.initials: EH
authors.lastname: Farrior
mesh_terms: D002245:Carbon Dioxide; D004867:Equipment Design; D004869:Equipment Safety; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D007834:Lasers; D012867:Skin / Q000528:radiation effects
chemical_list: D002245:Carbon Dioxide