Should We Pay More Attention to Endotracheal Tube Fixation during Anesthesia—Surveys from Chinese Anesthesiologists for Endotracheal Tube Fixation and Endotracheal Tube Displacement in 2014 and 2020

Abstract

Background: Displacement of endotracheal tube (ETT) can result in endobronchial intubation and accidental extubation that severely threatens safety of surgical patients. However, few surveys have investigated intraoperative ETT displacement experienced by anesthesiologists. The objective of these surveys was to investigate ETT fixation method and ETT displacement during general anesthesia experienced by anesthesiologists in China in 2014 and 2020. Methods: A questionnaire was designed with twenty questions and randomly distributed to anesthesiologists in two survey methods. In 2014, we collected responses from anesthesiologists who participated in the 22nd annual meeting of the Chinese Society of Anesthesiology in a face-to-face setting; in 2020, anesthesiologists from twenty-eight provinces completed the questionnaire through an online questionnaire survey platform. Differences in the responses from the anesthesiologists in 2014 and 2020 were assessed with a chi-square test. Results: In total, 568 questionnaires were collected, of which 541 questionnaires were valid (valid response rate 95.2%). A majority of the respondents (65.6%) had experienced ETT displacement, and 4.3% of respondents had experienced serious complications due to ETT displacement. Three hundred and twenty-nine respondents (60.8%) fixed the ETT with adhesive tape in the shape of the letter X. A majority of respondents considered the influence of surgical site, body position (97.8% of all respondents), and age (77.1% of all respondents) on fixing the ETT. Adhesive tape was the most commonly used material to fix the ETT (90.4% of the respondents). Conclusion: During clinical anesthesia, a majority of anesthesiologists experienced ETT displacement that can result in serious consequences. Therefore, the management of ETT should be a priority during the operation.