No Murphy Eye

The Murphy eye presents a challenge for cuff placement on smaller ETTs. Removing the Murphy eye on the Shiley™ pediatric ETT with TaperGuard™ cuff improves the margin of safety by2,4:

  • Allowing the TaperGuard™ cuff to be located closer to the tube tip, to help ensure the cuff is reliably placed within the trachea
  • Preventing the cuff from pressuring the laryngeal wall
  • Reducing the risk of endobronchial intubation

A shorter, inverted TaperGuard™ cuff

Compared to traditional barrel-shaped cuffs, the shorter TaperGuard™ cuff on the Shiley™ pediatric ETT helps support cuff placement in the trachea and improves sealing. This low-volume, low-pressure, taper-shaped cuff5,6:

  • Uses less material, which helps ease insertion past the vocal cords
  • Requires less volume to fill the cuff
  • Decreases aspirations
  • Reduces cuff pressure on tracheal tissues
  • Helps ease insertion past the cricoid due to the shorter cuff-to tip distance
  • †Compared to the adult version.

  • ‡As indicated by ISO 5361:2016.

  • 1. J. Holzki, K Brown, R. Carroll, C. Cote. The anatomy of the pediatric airway: Has our knowledge changed in 120 years? A review of historic and recent investigations of the anatomy of the pediatric larynx. Pediatric Anesthesia. 2017(28):13–22.

  • 2. Ho AM, Aun CS, Karmakar MK. The margin of safety associated with the use of cuffed pediatric tracheal tubes. Anesthesia. 2002;57(2):173–175.

  • 3. Bhardwaj N. Pediatric cuffed endotracheal tubes. J of Anaesthesiol Clin Pharmacol. 2013; 29(1):13–18.

  • 4. Weiss M, Knirsch W, Kretschmar O, et al. Tracheal tube-tip displacement in children during head-neck movement — a radiological assessment. Br J Anaesth. 2006;96(4):486–491.

  • 5. Lichtenthal PR, Wood L, Wong A, Borg U. Pressure applied to tracheal wall by barrel and taper shaped cuffs. Proc American Society of Anesthesiologists Annual Meeting. 2011:A1054.

  • 6. Lichtenthal PR, Maul D, Borg U. Do tracheal tubes prevent microaspiration? Br J Anaesth. 2011;107(5):821–822.

  • 7. Aker J. An emerging clinical paradigm: the cuffed pediatric endotracheal tube. AANA Journal. 2008;76(4):293–300.

  • 8. Haas CF, Eakin RM, Konkle MA, Blank R. Endotracheal tubes: old and new. Respir Care. 2014;59(6):933–955.

  • 9. Weiss M, Gerber AC, Dullenkopf A. Appropriate placement of intubation depth marks in a new cuffed paediatric tracheal tube. Br J Anaesth. 2005;94(1):80–87.

  • The Shiley™ endotracheal tube is indicated for oral and/or nasal intubation of the trachea for anesthesia and for general airway management. The endotracheal tube is a sterile, single patient-use medical device not intended to be reprocessed (cleaned, disinfected/sterilized) and used on another patient. Expert clinical judgement should be exercised in the selection of the appropriate type and size endotracheal tube for each individual patient. Please refer to the product manual for detailed usage and troubleshooting instructions. For further information, please contact your Medtronic representative or view the product manual at manuals.medtronic.com.