Should We Pay More Attention to Endotracheal Tube Fixation during Anesthesia—Surveys from Chinese Anesthesiologists for Endotracheal Tube Fixation and Endotracheal Tube Displacement in 2014 and 2020

Background: Displacement of endotracheal tube (ETT) can result in endobronchial intubation and accidental extubation that severely threatens safety of surgical patients. However, few surveys have investigated intraoperative ETT displacement experienced by anesthesiologists. The objective of these surveys was to investigate ETT fixation method and ETT displacement during general anesthesia experienced by anesthesiologists in China in 2014 and 2020. Methods: A questionnaire was designed with twenty questions and randomly distributed to anesthesiologists in two survey methods. In 2014, we collected responses from anesthesiologists who participated in the 22nd annual meeting of the Chinese Society of Anesthesiology in a face-to-face setting;in 2020, anesthesiologists from twenty-eight provinces completed the questionnaire through an online questionnaire survey platform. Differences in the responses from the anesthesiologists in 2014 and 2020 were assessed with a chi-square test. Results: In total, 568 questionnaires were collected, of which 541 questionnaires were valid (valid response rate 95.2%). A majority of the respondents (65.6%) had experienced ETT displacement, and 4.3% of respondents had experienced serious complications due to ETT displacement. Three hundred and twenty-nine respondents (60.8%) fixed the ETT with adhesive tape in the shape of the letter X. A majority of respondents considered the influence of surgical site, body position (97.8% of all respondents), and age (77.1% of all respondents) on fixing the ETT. Adhesive tape was the most commonly used material to fix the ETT (90.4% of the respondents). Conclusion: During clinical anesthesia, a majority of anesthesiologists experienced ETT displacement that can result in serious consequences. Therefore, the management of ETT should be a priority during the operation.

A Comparison of Five Adhesive Tapes for Securing Endotracheal Tube in a Manikin

Background: Adhesive tape is the common method for endotracheal tube (ETT) secured to prevent tube displacement and unplanned extubation in an anesthesia setting. However, it is unclear which tape is superior for ETT fixation among the various tapes used in clinical practice. This study examines the force required to move 2 cm ETT and extubate ETT from an intubation manikin with five different adhesive tapes. Methods: We orally intubated an adult intubation manikin with an inner-diameter 7.5 mm ETT, inflated the cuff to 20 cm H2O. Then we secured ETT with five different adhesive tapes (Transpore tapeTM, Urgosyval tape®, TransporeTM White tape, Multipore tape, DuraporeTM tape) in a conventional fixation method. A digital force gauge was connected to the ETT and pulled in a direction erected to the oral cavity. We measured the force required to move 2 cm ETT and extubate ETT (defined as 5 cm ETT displacement) from the manikin. Data were analyzed with one-way analysis of variance, with P < 0.05. Results: DuraporeTM tape had the largest average force of 2 cm displacement (58.9 ± 5.7N) (P < 0.05). The extubation force of DuraporeTM tape (59.7 ± 4.9N) was larger than Urgosyval® tape (40.4 ± 2.9N) (P < 0.05), TransporeTM tape (48.7 ± 5.1N) (P < 0.05), Transpore WhiteTM tape (48.7 ± 5.1N) (P < 0.05). Conclusion: DuraporeTM tape was superior to the other four tapes (TransporeTM tape, Urgosyval® tape, TransporeTM white tape, Multipore tape) in holding the ETT in place in the manikin.

Transition-edge sensors using Mo/Au/Au tri-layer films

The proximity effect to reduce the transition temperature of a superconducting film is frequently used in transitionedge sensors. Here, we develop these transition-edge sensors using Mo/Au/Au tri-layer films to detect soft x-rays. They are equipped with an overhanging photon absorber. We reduce the fabrication complexity by integrating the sensor patterning with the tri-layer film formation. We determine the electro-thermal parameters of the sensors through a series of resistance vs. temperature and current vs. voltage measurements. We also demonstrate their energy-resolving capability by using a55Fe radioactive x-ray source. The best energy resolution was approximately 6.66 eV at 5.9 keV, with a theoretical count rate of 500 Hz.

新型耐碱蛋白A介质的制备与性能

以蛋白A结构中耐碱性更好的C区为基础,构建一种新型耐碱蛋白A,并偶联至琼脂糖基质,获得新型耐碱蛋白A亲和层析介质,分别用激光共聚焦显微镜和石英晶体微天平研究了人免疫球蛋白(h Ig G)与蛋白A介质的结合过程。结果表明,该介质具有较商品配基更高的结合力和稳定的再生性能,hIgG动态载量达62.0 mg/mL,40次再生操作后载量为初始载量的84%。该介质在抗体纯化领域具有较好的应用前景。