What is the safest endotracheal tube for Nd-YAG laser surgery? A comparative study.

To determine whether a safe endotracheal tube for Nd-YAG surgery could be found, an Nd-YAG laser operating at 50 W was directed at six different endotracheal tubes that had 5 L/min of oxygen flowing through them. A plain Rusch red rubber endotracheal tube, a Bivona Fome-cuff laser endotracheal tube, a stainless steel Mallinckrodt Laser-Flex endotracheal tube, and a Xomed Laser-shield endotracheal tube were all ignited and perforated by the laser within 12 s. The combustion of the Mallinckrodt endotracheal tube can be explained by the high energy density of the laser that, in rapidly heating the metal, was able to cause its combustion in 100% oxygen. Red rubber endotracheal tubes wrapped with 3M No. 425 or Venture copper foil tape were unaffected by 1 min of exposure to the laser beam. They are recommended for clinical use.