The lengths of trachea and main bronchus in Chinese Shanghai population

Ge, Xiahui; Huang, Haidong; Bai, Chong; Guo, Xuejun; Kosmıdis, Christoforos; Sapalidis, Konstantinos; Baka, Sofia; Tsakiridis, Kosmas; Hohenforst-Schmidt, Wolfgang; Freitag, Lutz; Vagionas, Anastasios; Drevelegas, Konstantinos

doi:10.1038/s41598-021-81744-0

Cited by 10 publications

(8 citation statements)

References 12 publications

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“…Similarly, we did not investigate the difference between 3D imaging and bronchoscopy measurement. Although bronchoscopy is a preoperative examination for TRR, measuring the tracheal length from the vocal cord to the carina using bronchoscopy is different from 3D imaging measurement ( 29 ). Last, the usefulness of data regarding the tracheal length in TRR remains unclear, since there are no data on the tracheal length of patients who underwent TRR.…”

Section: Discussionmentioning

confidence: 99%

Significance of the evaluation of tracheal length using a three-dimensional imaging workstation

Matsuoka¹,

Shimizu²,

Koike³

et al. 2022

J Thorac Dis

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Background: Limited information is available on the total tracheal length and its other characteristics for tracheal surgery. This study aimed to investigate the reference value of tracheal length and assess its relationship with physiological variables. Methods:We measured the tracheal length of 215 patients (107 men and 108 women) who underwent contrast-enhanced computed tomography before thoracic surgery using a three-dimensional imaging workstation. Pearson correlation analysis and multiple linear regression analysis were performed to investigate the relationship between the total tracheal length (cervical and thoracic) and common physiological parameters. Results:The mean total tracheal length was 11.5±1 cm (range, 8.8-14.4 cm); 8% of the patients had a total tracheal length <10 cm. The cervical trachea was significantly shorter in men than in women (2.9±1.3 vs.3.8±1.3 cm, P<0.001), whereas the thoracic trachea was significantly longer in men than in women (8.9±1.1 vs. 7.4±1.1 cm, P<0.001). Correlation analysis showed that the total tracheal length was positively associated with height in both sexes, while the height was positively associated with only cervical tracheal length. In the multiple linear regression analysis, the total tracheal length was influenced most by height, while cervical and thoracic tracheal lengths were influenced most by sex. Older age was also an independent contributor to a shorter cervical trachea and longer thoracic trachea in both sexes. Conclusions:The total tracheal length ranged from short to long in individuals, and characteristics of tracheal length varied with height, age, sex, and part of the trachea. We should thus be aware of the tracheal length of each patient for appropriate tracheal management.

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Section: Discussionmentioning

confidence: 99%

Significance of the evaluation of tracheal length using a three-dimensional imaging workstation

Matsuoka¹,

Shimizu²,

Koike³

et al. 2022

J Thorac Dis

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“…± 14.59 yrs. [3]. Our patient has a measured trachea length of 11.7 cm from vocal cords to carina and 11.1 cm from vocal cords to the mainstem bronchi as measured by radiographical imaging.…”

Section: Discussionmentioning

confidence: 86%

Adverse event using Medtronic NIM™ EMG endotracheal tube on a patient receiving anesthesia for hemithyroidectomy: a case report

2022

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Background The neural integrity monitor (NIM) electromyogram (EMG) endotracheal (ET) tube is a widely used device to monitor neural response through muscle activity. It is helpful in surgical procedures with high risk of damaging delicate structures in the head and neck. This case provides a thorough analysis of an adverse event that was encountered in the operating room, which others can hopefully learn from. Case presentation We are reporting a case in which a patient undergoing hemithyroidectomy had experienced an adverse event using the Medtronic NIM™ EMG endotracheal tube. After successful induction and intubation, confirming the proper positioning of the electrode wires was necessary before the incision could be made. Upon reexamination, the patient suddenly became difficult to ventilate with increased peak airway pressure, decreased tidal volume, and end tidal CO2. This episode lasted approximately 15 min and the patient’s condition remained stable despite low tidal volumes. The problem was unexpectedly resolved upon deflation of the cuff of the ET tube. Conclusions There are several similar reports of these endotracheal tubes causing obstruction, especially those in which overinflation of the cuff caused cuff herniation and blockage of the Murphy eye and the bevel. It is currently believed that the design of this tube allowed for the obstruction to occur. The patient’s short body habitus may have also been a small contributing factor. The distance that the electrodes must sit within the vocal cords to the tip of the bevel is longer in this type of ET tube compared with a standard ET tube. The distance from the true vocal cords to where the cuff sits in the trachea is also greater in this model NIM EMG tube. There was no confirmation of the exact obstructive process that took place, however, confirming the tube and cuff positioning would have been optimal.

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“…Various methods have been described for accurate tube positioning including age, height, and ETT internal diameter (ID). Other study have shown that the length of trachea may vary according to gender 25 . Moreover, weight can be the independent variable for the length of the orotracheal tube in previous study 26 .…”

Section: Methodsmentioning

confidence: 94%

Predicting the risk of inappropriate depth of endotracheal intubation in pediatric patients using machine learning approaches

Shim

Lee

et al. 2023

Sci Rep

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Endotracheal tube (ET) misplacement is common in pediatric patients, which can lead to the serious complication. It would be helpful if there is an easy-to-use tool to predict the optimal ET depth considering in each patient’s characteristics. Therefore, we plan to develop a novel machine learning (ML) model to predict the appropriate ET depth in pediatric patients. This study retrospectively collected data from 1436 pediatric patients aged < 7 years who underwent chest x-ray examination in an intubated state. Patient data including age, sex, height weight, the internal diameter (ID) of the ET, and ET depth were collected from electronic medical records and chest x-ray. Among these, 1436 data were divided into training (70%, n = 1007) and testing (30%, n = 429) datasets. The training dataset was used to build the appropriate ET depth estimation model, while the test dataset was used to compare the model performance with the formula-based methods such as age-based method, height-based method and tube-ID method. The rate of inappropriate ET location was significantly lower in our ML model (17.9%) compared to formula-based methods (35.7%, 62.2%, and 46.6%). The relative risk [95% confidence interval, CI] of an inappropriate ET location compared to ML model in the age-based, height-based, and tube ID-based method were 1.99 [1.56–2.52], 3.47 [2.80–4.30], and 2.60 [2.07–3.26], respectively. In addition, compared to ML model, the relative risk of shallow intubation tended to be higher in the age-based method, whereas the risk of the deep or endobronchial intubation tended to be higher in the height-based and the tube ID-based method. The use of our ML model was able to predict optimal ET depth for pediatric patients only with basic patient information and reduce the risk of inappropriate ET placement. It will be helpful to clinicians unfamiliar with pediatric tracheal intubation to determine the appropriate ET depth.

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The lengths of trachea and main bronchus in Chinese Shanghai population

Cited by 10 publications

References 12 publications

Significance of the evaluation of tracheal length using a three-dimensional imaging workstation

Significance of the evaluation of tracheal length using a three-dimensional imaging workstation

Adverse event using Medtronic NIM™ EMG endotracheal tube on a patient receiving anesthesia for hemithyroidectomy: a case report

Predicting the risk of inappropriate depth of endotracheal intubation in pediatric patients using machine learning approaches

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