Prevention of Endotracheal tube blockage by humidification

ABSTRACT: Endotracheal Intubation is an important procedure which is used for themaintenance of airway patency, used in ICU for critically ill patients andused in Operation Theatre for Surgical Patients. Prolonged endotrachealintubation can cause complications which includes the Endotracheal tubeblockage due to accumulation of thick secretions and mucus plugging.As Endotracheal tube blockage increases the airway resistance, providesimpaired ventilation and oxygen, it can be life threatening because it cancause sudden respiratory deterioration.Humidification of inspired gases is important for the patients who arereceiving mechanical ventilation.Normally, the inspired air is warm andhumidified by the upper airway, but when ET Tube is inserted in thepatient's airway , this natural conditioning system is bypassed. Due to this ,the dry air reaches the lower respiratory tract and can cause dryness ofmucosa of the airway and can affect the mucociliary function and makesthe secretions thick which causes the blockage of ET Tube due to theiraccumulation in ET Tube.Humidification can be Provided by two methods -one is Active heatedhumidifiers which warms the air and add the moisture in inspired air AndAnother is Heat And Moisture exchanger which collects the heat andmoisture from the expired air and deliver this collected heat and moisturein next breath to the Patient. An appropriate Humidification System shouldbe used according to the patient’s condition and monitored continuously ,so that the patient can receive adequate humidified air to prevent theEndotracheal tube blockage.This is also suggested by the evidence, that Et Tube blockage can bereduced by the proper use of humidification. Reduction of ET Tubeblockage in ICU quality improvement study is reported by use of evidencebased active and passive humidification practices. Recently in 2026, 40%reduction in Et Tube blockage is reported in Neonatal ICU by Standardizedhumidification practices.So, to prevent the ET Tube blockage , adequate humidification,assessment of mucus, proper suctioning,appropriate selection ofhumidification is important.Keywords: Endotracheal Tube , ET Tube Blockage, Humidification,Mechanical Ventilation, heated Humidifier, Hear and Moistureexchanger,ICU.