Ultrasonographic Estimation of Endotracheal Case Series Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study
Introduction: Choosing the correct Endotracheal Tube (ETT) size is important in paediatric anaesthesia. The subglottic diameter being the narrowest diameter of the paediatric upper airway plays an important role in appropriate ETT size selection. Aim: This study was planned to determine the accu...
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doaj-11b8bdcd1a1445149519e1b4b011feb12020-11-25T03:04:50ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-05-01115UC05UC0810.7860/JCDR/2017/25905.9838Ultrasonographic Estimation of Endotracheal Case Series Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective StudyJagadish G Sutagatti0Ranjana Raja1Madhuri S Kurdi2Associate Professor, Department of Radiodiagnosis, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.Resident, Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.Professor, Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.Introduction: Choosing the correct Endotracheal Tube (ETT) size is important in paediatric anaesthesia. The subglottic diameter being the narrowest diameter of the paediatric upper airway plays an important role in appropriate ETT size selection. Aim: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. The secondary outcome was to assess the number of times the tube was changed based on air leak test for USG estimated tube size. Materials and Methods: After ethical committee approval, a prospective clinical observational study for a period of one year was conducted on 75 children (power of study 80%, confidence interval 95%) aged one to 14 years of American Society of Anaesthesiologists Physical Status (ASA) I and II undergoing elective surgery under general anaesthesia with orotracheal intubation. Parental consent was obtained. Preanaesthetic ultrasonography was performed on every patient at the subglottic region. The tracheal subglottic diameter was estimated to select the ETT size for cuffed and uncuffed tubes. The size estimated by USG and that based on age and height based formulae were compared with clinically used appropriate tube size. Data analysis was done using IBM Statistical Package for the Social Sciences (SPSS) version 20.0; One-way Analysis of Variance (ANOVA) and t-test for comparison were used. Results: USG predicted the appropriate ETT size (p<0.05) better than physical indices based formulae for cuffed and uncuffed tubes. The age based formula predicted the clinically used ETT size well (p=0.58) and the height based formula did not correlate with clinically used tube size (p=0.0002 – a statistically significant value). Eight patients required change of tube once. Conclusion: Ultrasonographic estimation of subglottic diameter is useful for optimal paediatric ETT size selection. USG is effective in estimating the appropriate sized ETT both for cuffed and uncuffed tubes.https://jcdr.net/articles/PDF/9838/25905_CE[Ra]_F(SS)_PF1(NEGH)_PFA(PNE).pdfcricoid cartilagegeneral anesthesiaglottisintubationultrasonography |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jagadish G Sutagatti Ranjana Raja Madhuri S Kurdi |
spellingShingle |
Jagadish G Sutagatti Ranjana Raja Madhuri S Kurdi Ultrasonographic Estimation of Endotracheal Case Series Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study Journal of Clinical and Diagnostic Research cricoid cartilage general anesthesia glottis intubation ultrasonography |
author_facet |
Jagadish G Sutagatti Ranjana Raja Madhuri S Kurdi |
author_sort |
Jagadish G Sutagatti |
title |
Ultrasonographic Estimation of Endotracheal Case Series Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study |
title_short |
Ultrasonographic Estimation of Endotracheal Case Series Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study |
title_full |
Ultrasonographic Estimation of Endotracheal Case Series Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study |
title_fullStr |
Ultrasonographic Estimation of Endotracheal Case Series Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study |
title_full_unstemmed |
Ultrasonographic Estimation of Endotracheal Case Series Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study |
title_sort |
ultrasonographic estimation of endotracheal case series tube size in paediatric patients and its comparison with physical indices based formulae: a prospective study |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2017-05-01 |
description |
Introduction: Choosing the correct Endotracheal Tube (ETT) size
is important in paediatric anaesthesia. The subglottic diameter
being the narrowest diameter of the paediatric upper airway
plays an important role in appropriate ETT size selection.
Aim: This study was planned to determine the accuracy of
Ultrasonography (USG) to assess the appropriate ETT size and
compare it with physical indices based formulae. The secondary
outcome was to assess the number of times the tube was
changed based on air leak test for USG estimated tube size.
Materials and Methods: After ethical committee approval,
a prospective clinical observational study for a period of one
year was conducted on 75 children (power of study 80%,
confidence interval 95%) aged one to 14 years of American
Society of Anaesthesiologists Physical Status (ASA) I and II
undergoing elective surgery under general anaesthesia with
orotracheal intubation. Parental consent was obtained. Preanaesthetic ultrasonography was performed on every patient
at the subglottic region. The tracheal subglottic diameter was
estimated to select the ETT size for cuffed and uncuffed tubes.
The size estimated by USG and that based on age and height
based formulae were compared with clinically used appropriate
tube size. Data analysis was done using IBM Statistical Package
for the Social Sciences (SPSS) version 20.0; One-way Analysis
of Variance (ANOVA) and t-test for comparison were used.
Results: USG predicted the appropriate ETT size (p<0.05) better
than physical indices based formulae for cuffed and uncuffed
tubes. The age based formula predicted the clinically used ETT
size well (p=0.58) and the height based formula did not correlate
with clinically used tube size (p=0.0002 – a statistically significant
value). Eight patients required change of tube once.
Conclusion: Ultrasonographic estimation of subglottic diameter
is useful for optimal paediatric ETT size selection. USG is
effective in estimating the appropriate sized ETT both for cuffed
and uncuffed tubes. |
topic |
cricoid cartilage general anesthesia glottis intubation ultrasonography |
url |
https://jcdr.net/articles/PDF/9838/25905_CE[Ra]_F(SS)_PF1(NEGH)_PFA(PNE).pdf |
work_keys_str_mv |
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