EndoFlex Tube: Sometimes Newer Is Not Better

Cheryl Lynn Horton, MD

The EndoFlex tracheal tube is harder to use than a conventional endotracheal tube in patients with cervical spine immobilization.

The EndoFlex® is a novel endotracheal tube with a malleable distal tip that obviates the need for an intubating stylet. Researchers compared the operating characteristics of the EndoFlex and conventional endotracheal tubes in 60 healthy adults undergoing elective surgery who were randomized to intubation with either device. All patients were placed in cervical collars to simulate a difficult intubation. Experienced anesthesiologists received training with the EndoFlex before the study.

There was no difference in median time to intubation (20 seconds) or first-attempt intubation success rate (90%) between groups. All patients were intubated within three attempts. Intubation-facilitating maneuvers were required more often with the EndoFlex tube (70% vs. 57%). Cormack-Lehane scores of I or II were obtained more often in the EndoFlex group (77% vs. 60%). Anesthesiologists rated the EndoFlex more difficult to use.

Citation(s):

Gaszynska E et al. A comparison of conventional tube and EndoFlex tube for tracheal intubation in patients with a cervical spine immobilisation. Scand J Trauma Resusc Emerg Med 2013 Nov 22; 21:79.