Effects of diameter, length, and circuit pressure on sound conductance through endotracheal tubes

We evaluated the acoustic frequency response of endotracheal tubes (ETs) to assess their effect on respiratory system sound transmission studies. White noise 150-3300 Hz was introduced into 4.0-, 6.0-, and 8.0-mm ETs and recorded at their proximal and distal ends. Four tubes of each size were studied at their original and normalized lengths, in straight and bent configurations, and at circuit pressures from 0 to 20 cmH₂O. The characteristics of the sound transmission were compared using an analysis of variance for repeated measures. The average transmission amplitude varied directly with tube diameter. The position of peaks and troughs on the amplitude frequency distribution depended on tube length but not on tube diameter. The angle of the phase-frequency plot correlated well with the length of the tube and was independent of its diameter. A 90° bend in the tube had no effect on its sound transmission. Increasing the circuit pressure above ambient modified the frequency response only if volume changes occurred in the test lung. When used to conduct sound into the respiratory system an ET affects the incident signal predictably depending on its length and diameter but not on its curvature or circuit pressure.