Endotracheal Tube Migration in Steep Trendelenburg Position With the Estape TrenMAX Positioning System

Marisol Alvarez; Sheila Llanes Rico; Jeffrey Tsai; Robin M Schaffer; Mohammed Masri; John Sciarra; Andrzej Kuchciak

doi:10.7759/cureus.20664

Endotracheal Tube Migration in Steep Trendelenburg Position With the Estape TrenMAX Positioning System

Cureus. 2021 Dec 24;13(12):e20664. doi: 10.7759/cureus.20664. eCollection 2021 Dec.

Authors

Marisol Alvarez¹, Sheila Llanes Rico¹, Jeffrey Tsai^{1

2}, Robin M Schaffer¹, Mohammed Masri³, John Sciarra¹, Andrzej Kuchciak¹

Affiliations

¹ Anesthesiology, Larkin Community Hospital-South Miami, South Miami, USA.
² Internal Medicine, Larkin Community Hospital-Palm Springs, Hialeah, USA.
³ General Surgery, Larkin Community Hospital-South Miami, South Miami, USA.

Abstract

The extent of endotracheal tube (ETT) migration was studied in 25 adult female patients undergoing robotic-assisted laparoscopic gynecologic surgery while in a steep Trendelenburg position secured with the Estape TrenMAX positioning system (Innovative Medical Products, Plainville, CT, USA). In four patients, the distance from the tip of the ETT to the carina did not change. In three patients, the distance from the tip of the ETT to the carina decreased by 1 centimeter (cm). In other patients, the distance from the tip of the ETT to the carina decreased by 0.2 to 0.5 cm. We concluded that the tip of the ETT moves closer to the carina in patients put in the extreme Trendelenburg position. These results were in alignment with the evidence base created by other researchers.

Keywords: academic anesthesiology; endotracheal tube; extreme trendelenburg position; obstetrics anesthesiologists; perioperative complications; positioning in the or; quality improvement and patient safety; robotic-assisted laparoscopic gynecologic surgery; trendelenburg; trenmax.