Endotrakeal

Endotrakeal, more commonly referred to as endotracheal in English, denotes a medical approach in which an endotracheal tube is inserted into the trachea to secure the airway and enable ventilation. The tube is usually placed through the mouth (orotracheal intubation) and guided past the vocal cords into the trachea, with the cuff inflated to seal the airway. The tube may also be placed via the nose (nasotracheal intubation) in selected cases.

Indications for endotracheal intubation include respiratory failure or impending failure, airway obstruction, risk of aspiration due to decreased consciousness, and the need for airway protection during anesthesia or critical care. Contraindications are situational rather than absolute, but may include instances where safer alternatives exist or where placement would pose excessive risk given the patient’s anatomy or injuries.

The procedure is typically performed by trained clinicians such as anesthesiologists or emergency physicians. It involves preoxygenation, administration of sedatives and, if needed, neuromuscular blockade, followed by insertion of the endotracheal tube with visualization tools such as a laryngoscope. A stylet may assist placement. Correct tube placement is confirmed by bilateral breath sounds, capnography (end-tidal CO2 detection), and chest imaging if available. After securing the tube, ongoing ventilation is provided by a ventilator or bag-valve device, with ongoing monitoring.

Complications can include misplacement (especially esophageal intubation), trauma to teeth or airway, pneumothorax, aspiration, infection, and tube dislodgement or obstruction. Prolonged use may lead to ventilator-associated pneumonia or airway injury, and in some patients a tracheostomy may be considered for longer-term airway management.