References
A is for airway: intubation guide for common species (part 1)
Abstract
Endotracheal intubation is a vital aspect of anaesthetic management in veterinary patients. It enables the delivery of volatile inhalants with 100% oxygen, reduces hypoxia risk, prevents environmental pollution and safeguards the airway against regurgitation and aspiration. Successful intubation requires knowledge of patient anatomy, appropriate endotracheal tube (ETT) and species-specific techniques. Proper measurement of ETTs, especially in smaller species, prevents complications such as bronchial intubation, which can cause uneven ventilation and hypoxia. This article reviews the types of ETTs, including Magill, Murphy, Cole and armoured tubes, discussing their materials, uses and features. It also addresses managing difficult intubations, highlighting essential preparation, equipment and techniques for challenging cases. A thorough understanding of intubation principles and preparation is essential for safe anaesthetic outcomes in veterinary practice.
When anaesthetising veterinary patients, it is recommended to intubate them with an appropriately sized and type-specific endotracheal tube (ETT), if the species can be intubated. This is especially important when using a volatile inhalant or if the patient requires manual or mechanical ventilation. This ensures there is no environmental pollution, provides personnel safety within the theatre, and delivers the volatile inhalant with 100% oxygen. The 100% oxygen will increase the fraction of inspired oxygen (FiO2) in the patients to prevent hypoxia, leading to hypoxemia. Therefore, increasing the FiO2 will increase the partial pressure of oxygen in the arterial blood (PaO2). With 100% oxygen, patients should have a PaO2 of 500 mmHg (5x FiO2) if a blood gas analysis was performed (Crawford, 2010).
Intubation reduces the risk of desaturation, prevents gas leakage and provides supported ventilation while protecting the airway from regurgitation and aspiration (Nutt et al, 2014). Other indications include emergencies, airway obstruction, deep sedation and patients with airway disease (Auckburally and Flaherty, 2017).
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