{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:22:38Z","timestamp":1780086158901,"version":"3.54.0"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2009322"],"award-info":[{"award-number":["2009322"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020265","name":"Stan Perron Charitable Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Children are sometimes transported via fixed or rotary wing aircraft for medical care. If they are intubated with a cuffed endotracheal tube (ETT), changes in environmental pressure during transport can alter cuff pressure. Cuff management in this setting varies widely by region and by organization. In this historical review, we sought to delineate the evolution of ETT cuff management in children undergoing aeromedical retrieval in order to progress the field toward an optimum strategy in the future.<\/jats:p><\/jats:sec><jats:sec><jats:title>Descriptions and Conclusions<\/jats:title><jats:p>Problems with extremely high ETT cuff pressures in adults due to altitude gain were identified by the 1970s. During subsequent decades, this topic was the subject of fervent research and device development, with a relative waning in interest more recently. Children, being transported less frequently and almost always with non\u2010cuffed ETTs, were not included in these research efforts. During a similar epoch, the field of hyperbaric medicine also recognized the issue of ETT cuff pressure changes and almost uniformly changed to cuff insufflation with an incompressible liquid. This was based on cuff pressure measurements and deductive reasoning, rather than on evidence from patient outcome trials. Aeromedical retrieval has not consistently adopted this technique. Further investigation and discussion on an optimum strategy of cuff management in aeromedical transport of children is needed to reach an agreement on best practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.15123","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T11:10:28Z","timestamp":1746097828000},"page":"504-510","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pediatric Endotracheal Tube Cuff Management at Altitude: Implications for Aeromedical Retrieval and Other Austere Environments"],"prefix":"10.1111","volume":"35","author":[{"given":"Matthew","family":"Desmond","sequence":"first","affiliation":[{"name":"Royal Flying Doctor Service (Queensland Section)  Cairns Australia"},{"name":"College of Medicine &amp; Dentistry James Cook University  Cairns Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8043-8541","authenticated-orcid":false,"given":"Britta S.","family":"von Ungern\u2010Sternberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital  Nedlands Australia"},{"name":"Perioperative Medicine Team, Perioperative Care Program The Kids Research Institute Australia  Nedlands Australia"},{"name":"Institute for Paediatric Perioperative Excellence The University of Western Australia  Perth Australia"},{"name":"Division of Emergency Medicine, Anaesthesia and Pain Medicine The University of Western Australia  Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14113"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998221100829"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/42.10.834"},{"key":"e_1_2_12_5_1","first-page":"1","article-title":"The Trachea and Cuff Induced Tracheal Injury: An Experimental Study on Causative Factors and Prevention","volume":"345","author":"Nordin U.","year":"1976","journal-title":"Acta Oto\u2010Laryngologica"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.288.6422.965"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2006.04785.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e318216b0d0"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102044.2008.05486.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198155060-00013"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.105786"},{"issue":"2","key":"e_1_2_12_12_1","first-page":"S1","article-title":"Length of the Cricoid and Trachea in Children: Predicting Intubation Depth to Prevent Subglottic Stenosis","volume":"132","author":"Propst E. 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