الفهرس 
Cuffed versus uncuffed tracheal tubes in neonates underwent elective surgery : a double blalinded randomized controlled trial
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Abstract
We reported that baseline lung ultrasound score as well as lung ultrasound at the end of surgery did not differ significantly in both groups apart from mild improvement of the total lung score in the cuffed ETT group compared to the uncuffed group. This finding may reflect the adequate and uniform ventilation in the cuffed ETT group. the small effect of the cuffed ETT ventilation on the lung ultrasound could be attributed to the short time of the procedures in the current study. Thomas et al. had reported an increased incidence of atelectasis in the uncuffed tube. This difference may be due to long mechanical ventilation period in the aforementioned study where they included neonates who are expected to be ventilated for more than 12 hours in the neonatal ICU, however, this respiratory complication did not increase the overall incidence of mortality.
Regarding postoperative complications, we have reported an overall insignificant difference between both groups, nevertheless, our study is not powered enough to measure the actual difference in respiratory complication. However, we found higher incidence of croup, requiring nebulized adrenaline and systemic steroids in the immediate postoperative period in the uncuffed ETT group compared to the cuffed group. the neonates in the uncuffed groups are 2.7 times more prone to postoperative croup compared to the cuffed group. This higher incidence could be attributed to 2 factors; the first factor is the higher incidence of ETT tube exchange in the uncuffed tube group which may cause airway trauma and edema. The second factor is that despite higher incidence of leak around the endotracheal tube in the uncuffed ETT group, the cricoid cartilage is not a complete rounded structure but rather and elliptical one, so the presence of leak around the ETT does not guarantee that airway is not traumatized. The likely higher incidence of postoperative respiratory and upper airway complications in children and neonates having uncuffed ETT was reported in previous studies and meta-analyses