Tracheal Intubation for Mechanical Ventilation: A Procedure to Insert Endotracheal Tube in Trachea of Rabbit Model

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The trachea is a tubular structure that connects the larynx or voice box to the bronchi in the lungs. At the proximal tracheal end, the larynx is covered by a cartilaginous flap called epiglottis which opens during breathing allowing the free movement of air into the trachea.

To perform tracheal intubation - a procedure to insert a tube in the trachea - place an anesthetized rabbit in the prone position. Widen the rabbit's mouth and insert a preliminary endotracheal tube into the oral cavity. This step facilitates the opening of the epiglottis and the tube moves inside the larynx.

Use the opening in the tube to pass a guide catheter inside the trachea until it reaches the desired location beyond the larynx. Remove the preliminary endotracheal tube while maintaining the guide catheter in its position.

Take a definitive endotracheal tube with an attached cuff - an inflatable portion - present at its end. Advance the tube onto the guide catheter to trace the guide's path eventually reaching the desired location in the trachea. Remove the guide catheter.

Use the terminal pilot balloon assembly to inflate the cuff. This step anchors the tube inside the lumen, sealing the airway to prevent leakage of air or fluids from the trachea. Post successful intubation, the rabbit is ready for mechanical ventilation.

After sedating the animals, place an intravenous cannula into the marginal vein from the ear, and keep it closed until intubation is complete. Place the rabbit in the prone position and maintain its head in vertical extension. Anesthetize the trachea locally by spraying 10% lidocaine.

Slide a small diameter endotracheal tube into the rabbit's trachea until airflow can be heard in the tube. This will open the larynx and facilitate the insertion of the definitive tube. Next, insert a guide into the tube to fix the position of the tube into the trachea. Remove the small diameter tube and slide the definitive endotracheal tube on the guide. Remove the guide and inflate the balloon at the end of the endotracheal tube to seal and block the device into the trachea.

Continuously perfuse fentanyl to induce analgesia, 2 to 4 mg/kg of propofol to induce anesthesia, and 4 mL/kg/hour of Ringer's acetate to maintain iso-volumetric conditions. Immediately ventilate the animal with 3% sevoflurane in pure oxygen.

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Last updated: 1 August 2026