+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The resistance to carbon dioxide laser ignition of a new endotracheal tube: Xomed Laser-Shield II

The resistance to carbon dioxide laser ignition of a new endotracheal tube: Xomed Laser-Shield II

Journal of Clinical Anesthesia 4(2): 89-92

To assess the resistance of a new endotracheal tube to penetration and ignition by a carbon dioxide (CO2) laser at a clinically relevant power setting. An unblinded, in vitro trial simulating clinical conditions. The operating room at a university medical center. None. A CO2 laser at 20W with a beam diameter of 1 mm was directed onto the Xomed Laser-Shield II at several points: both perpendicular and tangential to the portion of the tube covered by the protective wrap, to the unwrapped silicone tubing just proximal to the cuff, to the cuff filled with saline and methylene blue, and to the unwrapped silicone tubing distal to the cuff. Trials were performed with or without supplemental oxygen (O2) blown onto the study site and with a 6 L/min flow through the tube containing one of four concentrations of O2 in O2-air admixtures: 21%, 30%, 40%, and 100%. Under all conditions, the laser did not penetrate the protective wrap, but the overlying polytetrafluoroethylene (Teflon) sheet was vaporized to an area equal to the size of beam application. The cuff was penetrated by the laser within 5 seconds. The unprotected silicone protein of the tube was penetrated by the laser in approximately 5 seconds, and time to formation of a blowtorch phenomenon shortened with increasing the percentage of O2 flowing through the tube. The protective coating of the Xomed Laser-Shield II is laser-resistant, but the unprotected silicone proximal and distal to the cuff is laser-vulnerable and can, under certain conditions, promote a blowtorch phenomenon. This tube would be acceptable for use in oral and pharyngeal laser surgery, but we recommend its use only in well-ventilated areas, out of concern for exposure to the products of the pyrolysis of Teflon, specifically the development of polymer-fume fever.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 041737001

Download citation: RISBibTeXText

PMID: 1562342

DOI: 10.1016/0952-8180(92)90020-2

Related references

Airway fire during carbon dioxide laser surgery using a xomed laser endotracheal tube. Anesthesiology 72(4): 747-749, 1990

Comparison of xomed treace laser shield II and Sheridan Laser Trach Laser Resistant endotracheal tubes subjected to CO-2 laser. Anesthesiology 81(3A): A492, 1994

Indirect Ignition of the Endotracheal Tube During Carbon Dioxide Laser Surgery. Archives of Otolaryngology - Head and Neck Surgery 106(10): 639-641, 1980

Saline soaked pledgets prevent carbon dioxide laser-induced endotracheal tube cuff ignition. Journal of Clinical Anesthesia 7(5): 395-397, 1995

A comparison of carbon dioxide laser ignition of the xomed plastic and rubber tracheal tubes. Lasers in Surgery & Medicine (Suppl. 3): 58, 1991

Airway fire during co2 laser surgery using a Xomed Laser endotracheal tube. Anesthesiology 72(4): 747-749, 1990

A comparison of CO2 laser ignition of the Xomed, plastic, and rubber endotracheal tubes. Anesthesia and Analgesia 76(2): 391-393, 1993

Prevention of carbon dioxide laser induced endotracheal tube fires with the laser guard protective coating. Anesthesiology 71(3A): A419, 1989

Effect of extraluminal oxygen on carbon dioxide laser ignition of endotracheal tubes. Archives of Otolaryngology--Head & Neck Surgery 118(7): 722-724, 1992

Xomed laser-shield endotracheal tubes: flammable tubes still being used. Health Devices 20(11): 444-445, 1991

A new endotracheal tube for carbon dioxide and KTP laser surgery of the aerodigestive tract. Otolaryngology--Head and Neck Surgery 108(1): 96-99, 1993

Intraluminal gauge pressure affects tracheal tube ignition by carbon dioxide laser. Anesthesiology 73(3A): A1070, 1990

Experimental study of carbon dioxide laser induced histological effects on human fallopian tube determination of carbon dioxide laser parameters to be used in microsurgery. Lasers in Surgery & Medicine 7(2): 202-206, 1987

Endotracheal tube fires during carbon dioxide laser surgery on the larynx--a case report. Acta Anaesthesiologica Sinica 39(1): 53-56, 2001

Nitrogen insufflation decreases pvc endotracheal tube cuff flammability by the carbon dioxide laser. Lasers in Surgery & Medicine (Suppl. 2): 46, 1990