{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T18:33:27Z","timestamp":1783362807256,"version":"3.54.6"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR001442"],"award-info":[{"award-number":["UL1TR001442"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Endotracheal tubes (ETTs) are commonly associated with laryngeal injury that may be short lasting and temporary or more severe and life altering. Injury is believed to result from forces that these ETTs exert on the larynx. Here we quantify the forces of ETTs of various sizes on the laryngotracheal complex to gain a more quantitative understanding of these potential damaging forces. Here we also perform preclinical testing of a novel support device to offload these forces.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Endotracheal intubation was performed on a fresh human cadaver using various ETT sizes. A strain\u2010sensitive graphene nanosheet sensor and a commercially available force sensing resistor were secured behind the larynx, anterior to the prevertebral fascia. The forces exerted on the larynx were measured for each of the commonly used ETTs. A novel support device, ETT clip (Endo Clip), was attached to the ETTs and changes in these forces were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forces exerted on the laryngotracheal complex by various ETTs were observed to increase with increasing tube size. This pressure can be significantly reduced with a novel ETT clip.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Here we demonstrate the first quantitative measurement of forces that ETTs exert on the larynx. We demonstrate a novel device that can easily clip onto an ETT reducing pressure on the laryngotracheal complex. This preclinical test paves the way for a human clinical trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>5.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.1118","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T10:49:12Z","timestamp":1689850152000},"page":"989-995","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Endotracheal tube forces exerted on the larynx and a novel support device to reduce it"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3973-4023","authenticated-orcid":false,"given":"Andrew M.","family":"Vahabzadeh\u2010Hagh","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brennan P.","family":"Marsh\u2010Armstrong","sequence":"additional","affiliation":[{"name":"School of Medicine University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiv H.","family":"Patel","sequence":"additional","affiliation":[{"name":"School of Medicine University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Lindenmuth","sequence":"additional","affiliation":[{"name":"Jacobs School of Engineering University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyu","family":"Feng","sequence":"additional","affiliation":[{"name":"Jacobs School of Engineering University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rufu","family":"Gong","sequence":"additional","affiliation":[{"name":"Jacobs School of Engineering University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun\u2010An","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Structural Engineering University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Pierce","sequence":"additional","affiliation":[{"name":"Electrical &amp; Computer Engineering University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth J.","family":"Loh","sequence":"additional","affiliation":[{"name":"Department of Structural Engineering University of California, San Diego  La Jolla California USA"},{"name":"Materials Science &amp; Engineering University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Endotracheal Tube Intubation Techniques","author":"Alvarado AC","year":"2021"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.9278"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2011.1427"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0000000000005276"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000003368"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0265021505000529"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10245846"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13438"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542\u2010200306000\u201000050"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.11.004"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02868"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004311\u2010200007000\u201000006"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/admt.202000861"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.96.4.877"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20106576.1969.tb00750.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109343(81)90413\u20107"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489415608867"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27237"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.17085\/apm.22215"},{"issue":"1","key":"e_1_2_8_21_1","first-page":"12","article-title":"21 century \u2013 still no standardization","volume":"53","author":"Palaria U","year":"2009","journal-title":"Indian J Anaesth"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2018.01.001"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/won.0000000000000834"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.1118","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T16:18:53Z","timestamp":1695140333000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.1118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,20]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1002\/lio2.1118"],"URL":"https:\/\/doi.org\/10.1002\/lio2.1118","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,20]]},"assertion":[{"value":"2023-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}