endotrakea

Endotrakea, often used to refer to the endotracheal airway or endotracheal devices, encompasses both the trachea itself and the tubes placed within it to secure and manage the airway. In anatomical terms, the endotrachea (trachea) is a midline airway extending from the inferior larynx to the carina at about the level of the sternal angle (roughly T4–T5). It runs in the mediastinum, just anterior to the esophagus, and is supported by C-shaped cartilaginous rings that keep the passage open. The interior is lined with mucus-producing epithelium equipped with cilia to filter and humidify inspired air.

Functionally, the endotrachea conducts air to the lungs, conditions it through humidification, and protects the lower airways from aspiration by coordinating with the cough reflex and mucociliary clearance. In clinical practice, the term often refers to endotracheal intubation, a procedure to place an endotracheal tube within the trachea to secure the airway and enable controlled ventilation, particularly during anesthesia, critical illness, or airway obstruction.

Indications for intubation include loss of protective airway reflexes, respiratory failure, extensive surgical procedures under general anesthesia, and situations threatening airway patency. The procedure is typically performed with a laryngoscope and guided by clinical assessment, capnography, auscultation, and, when available, imaging to confirm tube placement.

Complications can include dental or soft tissue injury, esophageal or misplacement events, tracheal injury, mucus plugging, infection, and ventilator-associated complications such as pneumonia or barotrauma. Alternatives to endotracheal intubation include supraglottic devices, nasotracheal approaches, and tracheostomy, depending on the clinical scenario.