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Use of ultrasonography as a noninvasive decisive tool to determine the accurate endotracheal tube size in anesthetized children.
Arch Argent Pediatr. 2018 06 01; 116(3):172-178.AA

Abstract

BACKGROUND

It is hard to determine the appropriate size and correct tracheal position of endotracheal tube (ETT) in children. The aim of this study is to determine tracheal diameter in children by using ultrasonography technique as objective tool and compare it with commonly used aged based formulas for the ETT size estimation.

PATIENTS AND METHODS

Patients undergoing elective surgery in a tertiary children's hospital were prospectively enrolled. The subglottic transverse tracheal diameter was determined by ultrasonography. An anesthesiologist who was blind to ultrasonographic examination, determined the tube size and performed intubation by evaluating the space between vocal cords with the help of a direct laryngoscopic view. Ultrasonographically measured tracheal diameter, tube diameters, leak/pressure controls, and results of age-based tube size calculations were recorded.

RESULTS

A total of 61 patients, mean age of 12 ± 4.21 (2- 17) years and mean weight of 38 ± 22.94 (10-106) kg were enrolled. The diameter of trachea measured by ultsonography was 13.0 (11.4-15.1). Outer diameter (mm) of the ETT determined by anesthesiologist was 8.42 ± 1.43; calculated by Cole formula was 9.0 ± 1,42; calculated by Khine formula was 7.67 ± 1.46; calculated by Motoyama formula was 8.33 ± 1.42. ETT cuff was inflated after ETT placement due to leak in 31 (47.7%) patients. Tube was replaced by a larger tube due to excessive leak in one patient. Poor intraclass correlation was found between ultrasonographically determined tracheal diameter and aged based tube diameter calculations (tracheal diameter vs Cole [0.273], Khine [0.207], and Motoyama [0.230]).

CONCLUSION

Ultrasonographical determination of transverse tracheal diameter is a suitable method for determining the correct endotracheal tube size when compared with the age based formulas.

Authors+Show Affiliations

Department of Pediatric Surgery, Ankara University Medical Faculty, Ankara, Turkey. drggollu@yahoo.com.Department of Pediatric Anesthesiology, Ankara University Medical Faculty, Ankara, Turkey.Department of Pediatric Surgery, Ankara University Medical Faculty, Ankara, Turkey.Department of Pediatric Surgery, Ankara University Medical Faculty, Ankara, Turkey.Department of Pediatric Radiology, Ankara University Medical Faculty, Ankara, Turkey.Department of Pediatric Anesthesiology, Ankara University Medical Faculty, Ankara, Turkey.Department of Pediatric Radiology, Ankara University Medical Faculty, Ankara, Turkey.Department of Pediatric Anesthesiology, Ankara University Medical Faculty, Ankara, Turkey.Department of Pediatric Surgery, Ankara University Medical Faculty, Ankara, Turkey.

Pub Type(s)

Comparative Study
Journal Article

Language

eng spa

PubMed ID

29756700

Citation

Gollu, Gulnur, et al. "Use of Ultrasonography as a Noninvasive Decisive Tool to Determine the Accurate Endotracheal Tube Size in Anesthetized Children." Archivos Argentinos De Pediatria, vol. 116, no. 3, 2018, pp. 172-178.
Gollu G, Onat Bermede A, Khanmammadov F, et al. Use of ultrasonography as a noninvasive decisive tool to determine the accurate endotracheal tube size in anesthetized children. Arch Argent Pediatr. 2018;116(3):172-178.
Gollu, G., Onat Bermede, A., Khanmammadov, F., Ates, U., Genc, S., Selvi Can, O., Fitoz, S., Alanoglu, Z., & Yagmurlu, A. (2018). Use of ultrasonography as a noninvasive decisive tool to determine the accurate endotracheal tube size in anesthetized children. Archivos Argentinos De Pediatria, 116(3), 172-178. https://doi.org/10.5546/aap.2018.eng.172
Gollu G, et al. Use of Ultrasonography as a Noninvasive Decisive Tool to Determine the Accurate Endotracheal Tube Size in Anesthetized Children. Arch Argent Pediatr. 2018 06 1;116(3):172-178. PubMed PMID: 29756700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of ultrasonography as a noninvasive decisive tool to determine the accurate endotracheal tube size in anesthetized children. AU - Gollu,Gulnur, AU - Onat Bermede,A, AU - Khanmammadov,Farid, AU - Ates,Ufuk, AU - Genc,Sinan, AU - Selvi Can,Ozlem, AU - Fitoz,Suat, AU - Alanoglu,Zekeriyya, AU - Yagmurlu,Aydin, PY - 2016/12/23/received PY - 2017/10/02/accepted PY - 2018/5/15/entrez PY - 2018/5/15/pubmed PY - 2019/8/29/medline KW - Child KW - endotracheal intubation KW - trachea KW - ultrasonography SP - 172 EP - 178 JF - Archivos argentinos de pediatria JO - Arch Argent Pediatr VL - 116 IS - 3 N2 - BACKGROUND: It is hard to determine the appropriate size and correct tracheal position of endotracheal tube (ETT) in children. The aim of this study is to determine tracheal diameter in children by using ultrasonography technique as objective tool and compare it with commonly used aged based formulas for the ETT size estimation. PATIENTS AND METHODS: Patients undergoing elective surgery in a tertiary children's hospital were prospectively enrolled. The subglottic transverse tracheal diameter was determined by ultrasonography. An anesthesiologist who was blind to ultrasonographic examination, determined the tube size and performed intubation by evaluating the space between vocal cords with the help of a direct laryngoscopic view. Ultrasonographically measured tracheal diameter, tube diameters, leak/pressure controls, and results of age-based tube size calculations were recorded. RESULTS: A total of 61 patients, mean age of 12 ± 4.21 (2- 17) years and mean weight of 38 ± 22.94 (10-106) kg were enrolled. The diameter of trachea measured by ultsonography was 13.0 (11.4-15.1). Outer diameter (mm) of the ETT determined by anesthesiologist was 8.42 ± 1.43; calculated by Cole formula was 9.0 ± 1,42; calculated by Khine formula was 7.67 ± 1.46; calculated by Motoyama formula was 8.33 ± 1.42. ETT cuff was inflated after ETT placement due to leak in 31 (47.7%) patients. Tube was replaced by a larger tube due to excessive leak in one patient. Poor intraclass correlation was found between ultrasonographically determined tracheal diameter and aged based tube diameter calculations (tracheal diameter vs Cole [0.273], Khine [0.207], and Motoyama [0.230]). CONCLUSION: Ultrasonographical determination of transverse tracheal diameter is a suitable method for determining the correct endotracheal tube size when compared with the age based formulas. SN - 1668-3501 UR - https://www.unboundmedicine.com/medline/citation/29756700/Use_of_ultrasonography_as_a_noninvasive_decisive_tool_to_determine_the_accurate_endotracheal_tube_size_in_anesthetized_children_ L2 - https://doi.org/10.5546/aap.2018.eng.172 DB - PRIME DP - Unbound Medicine ER -