What type of airway is generally required for patients with significant airway swelling?

• A. Size 8.0 mm ET tube with a high pressure cuff
• B. Size 7.0 mm ET tube with a large volume, low pressure cuff
• C. Frova intubating catheter
• D. Tracheostomy tube

Answer: (B)

In cases of significant airway swelling, a size 7.0 mm endotracheal (ET) tube with a large volume, low pressure cuff is generally appropriate. The rationale for selecting a tube of this size lies in the need to secure the airway effectively while minimizing trauma to the already compromised airway structures.

A larger cuff allows for better sealing of the airway, which is crucial in preventing airway leaks and ensuring adequate ventilation. The low-pressure nature reduces the risk of cuff-related complications, such as ischemia or necrosis of the airway tissues, which can be especially important in swollen airways.

Intubation with a standard-sized ET tube for the patient’s age and size is generally preferred, and a 7.0 mm tube often provides a balance between securing the airway and accommodating some level of edema without causing further damage.

In contrast, other options such as a size 8.0 mm ET tube would be too large and could exacerbate swelling or trauma. The Frova intubating catheter is typically used for difficult intubations but does not provide the same level of airway protection or ventilation capabilities as a conventional ET tube. While a tracheostomy tube may be required in severe cases of obstruction, it is generally considered