Kinking of endotracheal tubes during maximal flexion of the atlanto-occipital joint in dogs

Endotracheal tubes manufactured from red rubber and polyvinyl chloride (PVC) were compared, using radiographic techniques, In dog cadavers, under in vitro conditions and in anaesthetised dogs (in vivo study). All endotracheal tubes were radiographed in 'neutral' and flexed positions and the percentage reduction in the ventrodorsal radiographical diameter of the tube was calculated. The red rubber tubes kinked completely in 40 per cent of the cadavers, 75 per cent of the in vitro study and 40 per cent of anaesthetised dogs. The PVC tubes kinked completely in only one case (in vivo study). However, these tubes had a mean reduction in diameter of 15 per cent in the dog cadaver study, :19 per cent in the in vitro study and 26 per cent in the in vivo study. During procedures in which the trachea is intubated and the atlanto-occipital joint of the patient must be flexed, PVC endotracheal tubes may be less prone to kinking than red rubber tubes.