A new way to manage artificial airway was introduced and estimated in this research. Six patients, who needed replacements of endotracheal tubes by varies reasons, were studied by using a guide wire through the existing endotracheal tube then removing the tube, and a new one was threaded over the wire into the trachea. During the procedure, the patient's HR,SaO2 and other clinical symptoms were monitored. It was compared with the control group of ten patients in which the old changing method was used. The result showed that average replacing time of study group, which was 30 sec, was much shorter than that of the control group, which was 20 min. there were no significant changes of HR and SaO2, no complications happened, and all the tubes were changed successfully with one time in study group. For the control group, the HR increased about 27 beats/min, SaO2 decreased about 10%, some patients were restlessness, had nose bleeding, or intubated into the esophagus and one patient had apnea. The success rate was only 67%. It is recommended that the new method is easier, less dangerous, less painful, and more successful.