The vital role of distal end location of endotracheal tubes in human trachea

Background Endotracheal Intubation (ETI) inserts an endotracheal tube (ETT) inside the human trachea to allow a proper mechanical ventilation of the lungs. Practitioners insert the ETT through the human vocal cords following a black-colored indicator on the ETT. Methods Advanced Computational Fluid Dynamics (CFD) provide the medical community with a better understanding of complex local phenomena that is impossible to reveal in practice. By employing advanced modeling and simulation techniques, this research investigated the distal end local positioning of the endotracheal tube close or far away from the Carina. Results The endotracheal tube distal end local position can induce significant changes in the local air velocity and the tracheal walls pressure. The ventilation pressure measured on the ventilators does not reflect the local intra-tracheal pressures and specifically what happens locally inside the trachea; e.g. in areas close to the carina. Conclusion Defining the future clinical impact of the ideal distance between the distal part of the intubation tube and the carina is essential, especially because nowadays ultrasound or fibroscopy techniques allow us to better quantify the position of the distal end of endotracheal tube with respect to the carina.