title: Roles of endotracheal tubes and slip joints in respiratory pressure loss: a laboratory study.
abstract: The endotracheal tube (ETT) constitutes a significant component of total airway resistance. However, a discrepancy between measured and theoretical values has been reported in airway resistance through ETTs. The causes of the discrepancy were estimated by physical and rheological simulations.
  
  
  
  The pressure losses through total lengths of ETTs and slip joints under a volumetric flow rate of 30 L/min were measured, and the pressure losses through the tubular parts of ETTs with internal diameters (IDs) of 6.0-, 6.5-, 7.0-, 7.5-, and 8.0 mm were measured. The Reynolds number of each setting was calculated, and the pressure losses through the total length of the ETT, the tubular part, and the slip joint of each size of tube were estimated.
  
  
  
  The Reynolds numbers were >5000 in all sizes of ETTs. Measured pressure losses were larger in small sized ETTs than in large sized ETTs-520.9 Pascals (Pa) in 6.0-mm ID and 136.4 Pa in 8.0-mm ID tubes. The measured pressure losses through the tubular part were comparable to the predicted values. The measured pressure losses through the slip joints were larger than the predicted values, and they accounted for approximately 25-40% of total pressure losses of the ETTs.
  
  
  
  Especially in small sized tubes, the pressure loss through the slip joint accounts for a large percentage of the total pressure loss through the ETT. The pressure loss through the slip joint may play a role in the discrepancy between measured and theoretical pressure losses through ETTs.
authors.affiliation: Department of Anesthesiology, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan. dzc01654@nifty.com.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takasugi
authors.affiliation: Department of Anesthesiology, Nara Hospital, Kindai University Faculty of Medicine, 1248-1 Otodacho, Ikoma, Nara, 630-0293, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Futagawa
authors.affiliation: Product Development Research Center, Daiken Medical Co. Ltd., 2-6-2, Ayumino, Izumi, Osaka, 594-1157, Japan.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Kazuhara
authors.affiliation: Product Development Research Center, Daiken Medical Co. Ltd., 2-6-2, Ayumino, Izumi, Osaka, 594-1157, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morishita
authors.affiliation: Department of Anesthesiology, Nara Hospital, Kindai University Faculty of Medicine, 1248-1 Otodacho, Ikoma, Nara, 630-0293, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Okuda
mesh_terms: D000403:Airway Resistance; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D011312:Pressure
keywords: Endotracheal tube; Pressure loss; Slip joint; Turbulent flow