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There is increasing interest in the use of cuffed paediatric tracheal tubes, these tubes have a number␣of advantages and disadvantages. One disadvantage is the decreased margin of safety associated with the use of cuffed tracheal tubes. When using an uncuffed tube, the margin of safety␣is approximately the length of the trachea, however, for a cuffed tube, this margin is reduced and is the length of the trachea minus the distance between the proximal edge of the cuff and the␣tip␣of the tube. We have found that, compared with traditional uncuffed tubes, cuffed tubes␣may␣be associated with a reduced margin of safety of approximately 50% or more.