Ultrasonographic Estimation of Endotracheal Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study

Sutagatti, Jagadish G; Raja, R; Kurdi, Madhuri S

doi:10.7860/jcdr/2017/25905.9838

Cited by 20 publications

(30 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found that the nearest ETT size with 0.5 mm increments by age was also significantly correlated to that by US. These results concur with those of Sutagatti et al (Sutagatti et al 2017) who found that comparing the ETT size estimated by US with the ETT used clinically did not show any significant difference (P = 1.000). Their study differed in that they used both cuffed and uncuffed ETT in a wider age range of children (1-14 years).…”

Section: Discussionsupporting

confidence: 92%

“…We have done US after induction of balanced general anesthesia including muscle relaxation as the tracheal diameter changes after muscle relaxation (Sutagatti et al 2017). Our US measurements were taken during the expiratory phase of the respiratory cycle to avoid fluctuations in tracheal diameters, while Schramm et al (Schramm et al 2012) had measured the MTSD preoperatively before induction of anesthesia without muscle relaxation, and this may explain their different results.…”

Section: Discussionmentioning

confidence: 99%

“…The true vocal cords were localized (seen as paired hyperechoic linear structures), and then the probe was moved caudally to visualize the cricoid arch. By US, the minimal transverse subglottic diameter (MTSD) was measured during the expiratory phase of the respiratory cycle (Berkow and Ariyo 2015;Sutagatti et al 2017;Schramm et al 2012).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Routine use of ultrasonography in prediction of uncuffed endotracheal tube size in pediatric patients

Mahran

Adlan

2019

Ain-Shams J Anesthesiol

View full text Add to dashboard Cite

Background and aims: Endotracheal intubation is a crucial skill in anesthesia. Uncuffed pediatric endotracheal tube (ETT) size can be calculated by various methods like age-based formula or by using ultrasound to measure minimal transverse subglottic diameter (MTSD). This study aimed to compare both age-based formula and ultrasound to assess the advantage of routine use of ultrasound to determine pediatric ETT size. Materials and methods: Forty children of 2-10 years of age, ASA class ≤ II, Mallampati airway classes I and II, scheduled for surgery away from the head and neck, were included. Uncuffed ETT size for each child was calculated using age-based formula. After induction of balanced general anesthesia, an ultrasound was done to measure MTSD and an endotracheal tube was selected accordingly. After intubation, an air leak test was done and the ETT was accordingly changed (if needed). Results: ETT size by age-based formula strongly correlated with the size measured by ultrasound (Pearson correlation 0. 913; P < 0.001). The percentage of the need to change the endotracheal tube according to the leak test was only 7.5%. Conclusion: The ETT size calculation was similar for both age-based formula and ultrasound. So, we could not justify the routine use of ultrasound for calculating ETT size for intubation in pediatric patients.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Routine use of ultrasonography in prediction of uncuffed endotracheal tube size in pediatric patients

Mahran

Adlan

2019

Ain-Shams J Anesthesiol

View full text Add to dashboard Cite

show abstract

“…Airway ultrasound has also been used to identify tracheal diameter, with some studies describing superiority of the technique to conventional sizing methods. [20][21][22][23][24][25][26] With a linear transducer typically used for vascular access placed transversely on the trachea below the level of the larynx, the air shadow generated by the internal surface of the trachea is measurable for appropriate tracheal diameter ( Fig. 3).…”

Section: Airway Assessmentmentioning

confidence: 99%

Point-of-care ultrasound in pediatric anesthesiology and critical care medicine

Dalesio

Pustavoitau

2018

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Ultrasound has increasingly become a clinical asset in the hands of the anesthesiologist and intensivist who cares for children. Though many applications for ultrasound parallel adult modalities, children as always are not simply small adults and benefit from the application of ultrasound to their management in various ways. Body composition and size are important factors that affect ultrasound performance in the child, as are the pathologies that may uniquely afflict children and aspects of procedures unique to this patient population. Ultrasound simplifies vascular access and other procedures by visualizing structures smaller than those in adults. Maturation of the thoracic cage presents challenges for the clinician performing pulmonary ultrasound though a greater proportion of the thorax can be seen. Moreover, ultrasound may provide unique solutions to sizing the airway and assessing it for cricothyroidotomy. Though cardiac ultrasound and neurosonology have historically been performed by well-developed diagnostic imaging services, emerging literature stresses the utility of clinician ultrasound in screening for pathology and providing serial observations for monitoring clinical status. Use of ultrasound is growing in clinical areas where time and diagnostic accuracy are crucial. Implementation of ultrasound at the bedside will require institutional support of education and credentialing. It is only natural that the pediatric anesthesiologist and intensivist will lead the incorporation of ultrasound in the future practice of these specialties.

show abstract

“…However, because of the individual variability, these calculation methods have a poor correlation, especially in children. 3,4 Recent studies have demonstrated that the transverse diameters of the cricoid cartilage are correlated with the outer diameter of the ETT, and ultrasonography has been used to predict the optimal ETT size by measuring the transverse diameters of the cricoid cartilage. 5,6 However, the accuracy of ultrasound to measure the cricoid cartilage diameter in children remains to be determined.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of ultrasound to measure the cricoid cartilage diameter in children

Hao

Zhang

et al. 2020

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Background: Ultrasonography is used to pre-operatively predict the endotracheal tube size required for intubation by measuring the cricoid cartilage diameter. This study aimed to determine the accuracy of ultrasound measurements of the transverse diameters of the cricoid cartilage in children. Methods: We examined 50 children who underwent magnetic resonance imaging (MRI) scans at the HongHui Hospital, Xi'an Jiaotong University, from February 2019 to December 2019. Each child underwent MRI and ultrasound scans for measurement of the transverse diameters of the cricoid cartilage. The data measured by each technique were compared using Bland-Altman analysis and linear regression analysis. Results: Results of linear regression and Bland-Altman analysis showed strong correlation in the level of agreement between MRI and ultrasound measurements (r = 0.94, P < .001). The estimated bias was 0.11 mm; precision, 0.25 mm; and the limit of agreement, −0.47 to 0.70 mm. Conclusion: Ultrasound is a reliable tool for measuring the transverse diameters of the cricoid cartilage in children.

show abstract

Ultrasonographic Estimation of Endotracheal Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study

Cited by 20 publications

References 8 publications

Routine use of ultrasonography in prediction of uncuffed endotracheal tube size in pediatric patients

Routine use of ultrasonography in prediction of uncuffed endotracheal tube size in pediatric patients

Point-of-care ultrasound in pediatric anesthesiology and critical care medicine

Accuracy of ultrasound to measure the cricoid cartilage diameter in children

Contact Info

Product

Resources

About