Pilot tubing repair: a technical note

Background: Endotracheal tubes are designed with multiple features to enhance patient safety during the delivery of anesthesia. Some of these features include the cuff, cuff line, and spring-loaded pilot balloon. Their purpose is to inflate the cuff in the patient’s airway to prevent aspiration, support oxygenation and ventilation, and prevent the leakage of volatile gasses. Procedures of the head and neck occur in close proximity to the airway and may result in damage to any of these parts of the endotracheal tube (ETT). Methods: The authors of this technical note describe a technique using an intravenous (IV) catheter, a Luer-Lock syringe, and tape to repair the cuff line in case of iatrogenic damage. Results: Use of this technique allows for provisional reinflation of a non-damaged cuff until the patient is ready for extubation. Conclusions: The authors of this technical note have described a method of re-inflating a cuff in the case of damage to the endotracheal tube’s pilot tube. While damage to the tube rarely occurs, it is a simple technique requiring equipment readily found in modern operating rooms that can prevent harm to a patient from a deflated cuff.