{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:53:37Z","timestamp":1787025217524,"version":"build-2736575974"},"reference-count":7,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018]]},"abstract":"\n Intubation for pediatric patients is frequently performed with an uncuffed endotracheal tube (ETT), which may result in an incomplete tracheal seal, resulting in gas leakage (leak). The purpose of this study was to assess the effect of (1) mouth opening and (2) throat pack placement in sealing and\/or minimizing this leak to an acceptable level while providing adequate tidal volumes in mechanically ventilated patients. This prospective study of 2- to 6-year-olds undergoing general anesthesia with nasal intubation for dental procedures in the New York University\u2013Lutheran Medical Center operating room was conducted between March 2015 and October 2015. Three sequential tidal volume (V\n T<\/jats:sub>\n ) measurements were recorded: postintubation with the neck extended, with mouth opened, and after throat pack placement. Twenty-five subjects were included in the analyses. For subjects in whom no leak was detected, only throat pack placement statistically improved V\n T<\/jats:sub>\n . This is in marked contrast to numerically large, statistically significant effects, relative to baseline, for mouth opening (\u00b123.2 mL,\n p<\/jats:italic>\n < .009, 21% increase from baseline) and throat pack placement (\u00b146 mL,\n p<\/jats:italic>\n < .009, 41% increase from baseline) when a leak was detected. In children 2\u20136 years of age, nasal intubation with uncuffed ETTs that have incomplete tracheal seal have improved V\n T<\/jats:sub>\n with mouth opening and throat pack placement. This finding suggests that the intubation procedure is a process that extends through positioning, mouth opening, and throat pack placement.\n <\/jats:p>","DOI":"10.2344\/anpr-65-03-13","type":"journal-article","created":{"date-parts":[[2019,1,3]],"date-time":"2019-01-03T20:13:09Z","timestamp":1546546389000},"page":"237-243","source":"Crossref","is-referenced-by-count":5,"title":["The Effects of Mouth Opening and Throat Pack Placement on Uncuffed Nasal Endotracheal Tube Leakage and Delivered Tidal Volumes in Mechanically Ventilated Pediatric Patients Undergoing Dental Procedures"],"prefix":"10.2344","volume":"65","author":[{"given":"Katie E.","family":"Bradford","sequence":"first","affiliation":[{"name":"Dental Anesthesiology, New York University\u2013Lutheran Medical Center, Brooklyn, New York, and University of Rochester, Eastman Institute for Oral Health, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis I.","family":"Siegelman","sequence":"additional","affiliation":[{"name":"Dental Anesthesiology, New York University\u2013Lutheran Medical Center, Brooklyn, New York, and University of Rochester, Eastman Institute for Oral Health, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter J.","family":"Psoter","sequence":"additional","affiliation":[{"name":"Dental Anesthesiology, New York University\u2013Lutheran Medical Center, Brooklyn, New York, and University of Rochester, Eastman Institute for Oral Health, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"key":"i0003-3006-65-4-237-b01","series-title":"Ochsner J","first-page":"52","article-title":"Pediatric cuffed endotracheal tubes: an evolution of care","volume":"11","author":"Taylor \n C,","year":"2011","unstructured":"Taylor \n C, \n \n \n Subaiya \n L, \n \n \n Corsino \n D. \n \n \n Pediatric cuffed endotracheal tubes: an evolution of care. Ochsner J. 2011;11:52\u201356."},{"key":"i0003-3006-65-4-237-b02","series-title":"Br J Anaesth","first-page":"78","article-title":"Shortcomings of cuffed paediatric tracheal tubes","volume":"92","author":"Weiss \n M,","year":"2004","unstructured":"Weiss \n M, \n \n \n Dullenkopf \n A, \n \n \n Gysin \n C, \n \n \n Dillier \n CM, \n \n \n Gerber \n AC. \n \n \n Shortcomings of cuffed paediatric tracheal tubes. Br J Anaesth. 2004;92:78\u201388."},{"issue":"3","key":"i0003-3006-65-4-237-b03","series-title":"Anesthesiology","first-page":"627","article-title":"Comparison of cuffed and uncuffed endotracheal tubes in young children during general anesthesia","volume":"86","author":"Khine \n HH,","year":"1997","unstructured":"Khine \n HH, \n \n \n Corddry \n DH, \n \n \n Kettrick \n RG, \n \n et al. \n Comparison of cuffed and uncuffed endotracheal tubes in young children during general anesthesia. Anesthesiology. 1997;86(3):627\u2013631."},{"key":"i0003-3006-65-4-237-b04","series-title":"J Anesth","first-page":"3","article-title":"Cuffed versus uncuffed endotracheal tubes in children: a meta-analysis","volume":"30","author":"Shi \n F,","year":"2016","unstructured":"Shi \n F, \n \n \n Xian \n Y, \n \n \n Xiong \n W, \n \n \n Zhou \n Q, \n \n \n Huang \n X. \n \n \n Cuffed versus uncuffed endotracheal tubes in children: a meta-analysis. J Anesth. 2016;30:3\u201311."},{"key":"i0003-3006-65-4-237-b05","series-title":"J Oral Maxillofac Surg","first-page":"1038","article-title":"The influence of mouth opening on oropharyngeal leak pressure, intracuff pressure, and cuff position with the laryngeal mask airway","volume":"68","author":"Sanuki \n T,","year":"2010","unstructured":"Sanuki \n T, \n \n \n Sugioka \n S, \n \n \n Hirokane \n M, \n \n et al. \n The influence of mouth opening on oropharyngeal leak pressure, intracuff pressure, and cuff position with the laryngeal mask airway. J Oral Maxillofac Surg. 2010;68:1038\u20131042."},{"key":"i0003-3006-65-4-237-b06","series-title":"J Oral Maxillofac Surg","first-page":"1018","article-title":"Optimal degree of mouth opening for laryngeal mask airway function during oral surgery","volume":"69","author":"Sanuki \n T,","year":"2011","unstructured":"Sanuki \n T, \n \n \n Sugioka \n S, \n \n \n Hirokane \n M, \n \n et al. \n Optimal degree of mouth opening for laryngeal mask airway function during oral surgery. J Oral Maxillofac Surg. 2011;69:1018\u20131022."},{"key":"i0003-3006-65-4-237-b07","series-title":"J Oral Maxillofac Surg","first-page":"1311","article-title":"Effect of head-neck extension on abnormality of laryngeal mask airway function resulting from opening the mouth","volume":"69","author":"Sanuki \n T,","year":"2011","unstructured":"Sanuki \n T, \n \n \n Sugioka \n S, \n \n \n Son \n H, \n \n \n Uda \n R, \n \n \n Akatsuka \n M, \n \n \n Kotani \n J. \n \n \n Effect of head-neck extension on abnormality of laryngeal mask airway function resulting from opening the mouth. J Oral Maxillofac Surg. 2011;69:1311\u20131315."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/65\/4\/article-p237.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/65\/4\/237\/2324182\/anpr-65-03-13.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/65\/4\/article-p237.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/65\/4\/article-p237.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T08:42:39Z","timestamp":1728290559000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/65\/4\/article-p237.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018]]},"references-count":7,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.2344\/anpr-65-03-13","relation":{},"ISSN":["0003-3006","1878-7177"],"issn-type":[{"value":"0003-3006","type":"print"},{"value":"1878-7177","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018]]}}}