Covidien 86446 Shiley Hi-Lo Oral/Nasal Endo-Tracheal Tube Cuffed, 5mm I.D. BX/10

Covidien 86446 Shiley Hi-Lo Oral/Nasal Endotracheal Tube Cuffed, 5mm I.D. BX/10

• Model: 86446
• Intermediate, Murphy Eye
• 5.0mm I.D., 6.9mm O.D.
• Box Dimensions: 4" x 13-3/4" x 6"
• Box of 10

The Shiley Hi‑Lo 86446 is a cuffed oral/nasal endotracheal tube that balances the needs for airway sealing and minimized wall contact pressure. Its Hi‑Lo (intermediate) cuff is shorter than full-length cuffs, which can be advantageous in reducing cuff contact area and potentially mitigating pressure injuries to the tracheal mucosa. The cuff is designed to conform to irregularities in the tracheal wall, distributing pressure more evenly and maintaining an effective seal at relatively low inflation pressures.

Because it includes a radiopaque stripe (tip-to-tip), clinicians can confirm proper placement of the tube via imaging (e.g. chest X‑ray), ensuring that the tip is in the desired tracheal location. The Murphy eye opening provides a safety vent in case the distal tip becomes occluded. The inclusion of a pilot balloon and self-sealing valve allows for controlled cuff inflation and monitoring during ventilation, which is essential for adjusting cuff pressure to maintain adequacy without overpressurizing.

In clinical settings, this tube is often selected for situations where both oral and nasal intubation are possibilities—such as maxillofacial surgery, ENT procedures, or general anesthesia requiring flexibility in approach. Because the cuff is somewhat shorter, it may be preferred when space is limited or when avoiding cuff migration into narrower tracheal segments is important. Users must monitor cuff pressure, maintain correct placement, verify patency, and manage humidification and secretion clearance as with all endotracheal tubes.