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Intubation with a cuffed tube is thought to provide the best protection against aspiration.
An excessive leak can usually be corrected by inserting a larger tube or a cuffed tube.
An excessive leak can sometimes be corrected through the placement of a larger (0.5 mm larger in internal diameter) endotracheal tube, although in difficult-to-ventilate patients even children may need to use cuffed tubes to allow for high pressure ventilation if the leak is too great to overcome with the ventilator.