When providing mechanical ventilation, what could result from a too-small endotracheal tube?

Choosing a too-small endotracheal tube can lead to increased work of breathing for the patient. A smaller tube has a narrower lumen, which creates higher resistance to airflow. When the airway resistance increases, the ventilator has to work harder to deliver an adequate tidal volume to the patient. This greater effort often results in difficulty maintaining proper ventilation and can tire the respiratory muscles, potentially leading to increased respiratory rates and further complications.

Using a smaller diameter tube can also compromise the effective delivery of oxygen, as well as airflow during both spontaneous and mechanical breaths. The decrease in airflow can lead to inadequate ventilation and hypoxia, further burdening the patient and complicating management efforts. Thus, while this situation does not support optimal patient outcomes, it clearly emphasizes the importance of selecting an appropriately sized endotracheal tube for effective mechanical ventilation.