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Concern about pressure-related subglottic injury from cuffed endotracheal tubes in young children has led to mixed recommendations and controversy about their use. Previous research with older high-pressure cuffed tubes demonstrated an unacceptably high incidence of complications, including subglottic stenosis. In a manufacturer-sponsored, multicenter European study, researchers compared the incidence of postextubation morbidity in 2246 children (age range, birth to 5 years) who were randomized to use of a modern high-volume, low-pressure cuffed tube or an uncuffed tube during intubation for general anesthesia.
The incidence of postextubation stridor (an indicator of mucosal injury) was similar in the cuffed and uncuffed groups (4.4% and 4.7…