Role of ultrasound compared to age‐related formulas for uncuffed endotracheal intubation in a pediatric population

Schramm, Christoph; Knop, Joachim; Jensen, Katrin; Plaschke, Konstanze

doi:10.1111/j.1460-9592.2012.03889.x

Cited by 99 publications

(120 citation statements)

References 19 publications

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“…In a pilot study, role of ultrasound and its usefulness in predicting the tracheal diameter in paediatric patients were studied. 5 In the study, a prospective clinical study like the pilot study showed a higher correlation between ETT used clinically and ETT determined by ultrasound than between ETT used clinically and ETT determined by age based formula. With the aid of ultrasonography we could measure the air-column width at the level of the cricoid and select the optimal sized ETT for intubation in less than 2 minutes.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies shows that the rate of agreement of age-based ETT size selection using the Cole formula is as low as 47-77. 5 Height-based technique such as Broselow tape can be used to compensate for individual variation in growth. However, these methods have many limitations because these formulas cannot consider variation in the growth of various internal organs.…”

Section: Discussionmentioning

confidence: 99%

“…These formulas which are based on age are often unreliable and may end up in repeated laryngoscopy for selecting the correct sized ETT. 4,5 This…”

Section: Introductionmentioning

confidence: 99%

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Comparative study on prediction of paediatric endotracheal tube size by ultrasonography and by age based formulas

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparative study on prediction of paediatric endotracheal tube size by ultrasonography and by age based formulas

et al. 2016

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“…The use of USG to predict appropriate ETT size in children has been previously studied (6)(7)(8)(9). These studies differ from each other, as shown in Table 3.…”

Section: Discussionmentioning

confidence: 99%

“…Visualisation of the paediatric subglottic airway diameter by ultrasonography (USG) can enable a practitioner to better predict ETT size, preventing unnecessary tube changes and airway trauma. Several studies have investigated ideal cuffed tube size selection in paediatric patients; however, all these studies, including those where ultrasonographic measurements were performed (6)(7)(8)(9), selected the initial ETT size according to age-based formulas. However, other than Bae et al (6), who investigated uncuffed tube size, none of these studies actually involved initial placement of an ETT according to ultrasonographic measurements.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic Measurement of Subglottic Diameter for Paediatric Cuffed Endotracheal Tube Size Selection: Feasibility Report

Altun¹,

Orhan-Sungur²,

Ali³

et al. 2017

Turk J Anaesth Reanim

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Amaç: Bu fizibiliti çalışmasının amacı pediyatrik hastalarda uygun büyüklükte kaflı endotrakeal tüpün (ETT) öngörülmesinde ultrasonografinin (USG) ilk girişim başarısını araştırmaktır.Yöntemler: Çalışmaya 1-10 yaş arası adenoidektomi veya adenotonsillektomi için endotrakeal entübasyon ile genel anestezi alan 50 çocuk dahil edilmiştir. Bütün katılımcılarda subglottik havayolunun transvers çapı krikoid kartilaj seviyesinden ventilasyon yapılmadan ultrasonografi ile ölçülmüştür. izin verilen maksimum ETT dış çapı (DÇ) ölçülen sublottik havayolu çapına göre seçilmiştir. Tüpün trakeadan geçişi sırasında dirençle karşılaşılması halinde veya havayolu basıncı >25 cm H 2 O'da duyulabilen kaçak varlığında ETT iç çapı (iÇ) 0,5 mm olan bir başkasıyla değişti-rilmiştir. Eğer havayolu basıncı <10 cm H 2 O'da duyulabilen kaçak varsa veya kaf basıncı >25 cm H 2 O'ya ulaşmıyorsa veya tepe havayolu basıncı ventilasyon sırasında >25 cm H 2 O ise tüp bir büyük çapla değiştirilmiştir. En iyi uyan ETT DÇ'ı iÇ'a dönüştü-rülmüştür. En uygun iÇ, ETT değiştirme ihtiyacı, ultrasonografi ile havayolu çapı ölçüm süresi, ve tepe havayolu basınçları kaydedilmiştir. Bulgular:Ultrosonografi ile ilk deneme başarı oranı %86, ETT 5 hastada bir numara büyük olan, 2 hastada bir numara küçükle değiştirilmiştir.Sonuç: Bulgularımız USG ile ölçülen subglottic çapın uygun pediyatrik ETT çapının belirlenmesinde daha güvenilir bir belirleyici olduğunu göstermiştir. Anahtar kelimeler: Pediatrik endotrakeal tüp, subglottik çap, ultrasonografiObjective: The aim of this feasibility study was to investigate the first attempt success of ultrasonography (USG) in paediatric patients in predicting an appropriate cuffed endotracheal tube (ETT) size. Methods:Fifty children who were 1-10 years of age and who received general anaesthesia with endotracheal intubation for adenoidectomy or adenotonsillectomy were enrolled in the study. In all participants, the transverse diameter of the subglottic airway was measured with USG at the cricoid level without ventilation. The outer diameter (OD) of the maximum allowable ETT was chosen according to the measured subglottic airway diameter. In the presence of resistance to passage of the tube into the trachea or in the absence of an audible leak at airway pressure of >25 cm H 2 O, the ETT was replaced with a tube whose internal diameter (ID) was 0.5 mm smaller. If a leak was audible at airway pressures of <10 cm H 2 O, if a seal could not be achieved with a cuff pressure of >25 cm H 2 O or if a peak airway pressure of >25 cm H 2 O was observed during ventilation, the tube was changed to a tube one size larger. The OD of the best-fit ETT was converted to the ID. The best-fit ID, the requirement for ETT replacement, the duration of airway diameter measurement by USG and the peak airway pressure were recorded. Results:The success rate of the first attempt with USG was 86%; the ETT was replaced in five patients with a tube one size larger and in two patients with a tube one size smaller. Conclusion:Our findings show the subglottic di...

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Neonatal and paediatric point‐of‐care ultrasound review

Pan

Lin

Tsui

2022

Australas J Ultrason Med

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Purpose Point‐of‐care ultrasound (POCUS) examinations for children and newborns are different from POCUS exams for adults due to dissimilarities in size and body composition, as well as distinct surgical procedures and pathologies in the paediatric patient. This review describes the major paediatric POCUS exams and how to perform them and summarizes the current evidence‐based perioperative applications of POCUS in paediatric and neonatal patients. Method Literature searches using PubMed and Google Scholar databases for the period from January 2000 to November 2021 that included MeSH headings of [ultrasonography] and [point of care systems] and keywords including “ultrasound” for studies involving children aged 0 to 18 years. Results Paediatric and neonatal POCUS exams can evaluate airway, gastric, pulmonary, cardiac, abdominal, vascular, and cerebral systems. Discussion POCUS is rapidly expanding in its utility and presence in the perioperative care of paediatric and neonatal patients as their anatomy and pathophysiology are uniquely suited for ultrasound imaging applications that extend beyond the standard adult POCUS exams. Conclusions Paediatric POCUS is a powerful adjunct that complements and augments clinical diagnostic evaluation and treatment.

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Role of ultrasound compared to age‐related formulas for uncuffed endotracheal intubation in a pediatric population

Abstract: Measuring MTDSA by ultrasound facilitates selection of the appropriate ETT in pediatric patients and may reduce the number of reintubations.

Cited by 99 publications

References 19 publications

Comparative study on prediction of paediatric endotracheal tube size by ultrasonography and by age based formulas

Comparative study on prediction of paediatric endotracheal tube size by ultrasonography and by age based formulas

Ultrasonographic Measurement of Subglottic Diameter for Paediatric Cuffed Endotracheal Tube Size Selection: Feasibility Report

Neonatal and paediatric point‐of‐care ultrasound review

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