title: Cuffed endotracheal tubes in children reduce sevoflurane and medical gas consumption and related costs.
abstract: BACKGROUND
  This study aims to evaluate sevoflurane and anaesthetic gas consumption using uncuffed vs. cuffed endotracheal tubes (ETT) in paediatric surgical patients.
  
  
  METHODS
  Uncuffed or cuffed ETT were used in paediatric patients (newborn to 5 years) undergoing elective surgery in a randomized order. Duration of assessment, lowest possible fresh gas flow (minimal allowed FGF: 0.5 l/min) and sevoflurane concentrations used were recorded. Consumption and costs for sevoflurane and medical gases were calculated.
  
  
  RESULTS
  Seventy children (35 uncuffed ETT/35 cuffed ETT), aged 1.73 (0.01-4.80) years, were enrolled. No significant differences in patient characteristics, study period and sevoflurane concentrations used were found between the two groups. Lowest possible FGF was significantly lower in the cuffed ETT group [1.0 (0.5-1.0) l/min] than in the uncuffed ETT group [2.0 (0.5-4.3) l/min], P<0.001. Sevoflurane consumption per patient was 16.1 (6.4-82.8) ml in the uncuffed ETT group and 6.2 (1.1-14.9) ml in the cuffed ETT group, P=0.003. Medical gas consumption was 129 (53-552) l in the uncuffed ETT group vs. 46 (9-149) l in the cuffed ETT group, P<0.001. The total costs for sevoflurane and medical gases were 13.4 (6.0-67.3)euro/patient in the uncuffed ETT group and 5.2 (1.0-12.5)euro/patient in the cuffed ETT group, P<0.001.
  
  
  CONCLUSIONS
  The use of cuffed ETT in children significantly reduced the costs of sevoflurane and medical gas consumption during anaesthesia. Increased costs for cuffed compared with uncuffed ETT were completely compensated by a reduction in sevoflurane and medical gas consumption.
authors.affiliation: Department of Anaesthesia and Intensive Care, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Eschertzhuber
authors.forename: B
authors.initials: B
authors.lastname: Salgo
authors.forename: A
authors.initials: A
authors.lastname: Schmitz
authors.forename: W
authors.initials: W
authors.lastname: Roth
authors.forename: A
authors.initials: A
authors.lastname: Frotzler
authors.forename: C H
authors.initials: CH
authors.lastname: Keller
authors.forename: A C
authors.initials: AC
authors.lastname: Gerber
authors.forename: M
authors.initials: M
authors.lastname: Weiss
mesh_terms: D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000032:analysis / Q000191:economics; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005740:Gases; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008738:Methyl Ethers / Q000008:administration & dosage* / Q000032:analysis / Q000191:economics; D010865:Pilot Projects; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D005740:Gases; D008738:Methyl Ethers; D000077149:Sevoflurane