Background And Aims: Selection of an appropriate endotracheal tube (ETT) in paediatric patients is a challenging situation. The purpose of this study was to compare whether measurement of subglottic diameter with ultrasound or the age-old little finger width correlates better with the outer diameter (OD) of the ETT used for intubation.
Methods: Following approval from the Institutional Ethics board and a written informed consent from parent or guardian, this prospective observational study was carried out on 60 American Society of Anesthesiologists physical status I and II patients aged 6 months-8 years, scheduled for elective surgery under general anaesthesia requiring oral endotracheal intubation. Preoperatively ultrasound-guided subglottic diameter (USGD) and little finger breadth (LFB) measurements were taken. On the day of surgery, intubation was done with an uncuffed ETT, whose OD was noted. The concordance and agreeability between two techniques for estimation of the OD of the ETT were measured by Lin's concordance correlation coefficient. Further, the bias and precision between the techniques and the inter-changeability of the techniques were assessed by using Bland and Altman and Mountain plotting, respectively.
Results: Lin's concordance correlation coefficient between USGD and LFB with the OD of the ETT was found to be 0.29 (0.13-0.41) and 0.46 (0.29-0.6), respectively.
Conclusion: Overall, neither USGD nor LFB can be used as a reliable tool to predict the OD of the ETT. Registered in Clinical Trial Registry of India. REF/2016/08/011955.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299778 | PMC |
| http://dx.doi.org/10.4103/ija.IJA_545_18 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Consequences of NICU Intubations: Incidence, Identifications, and Interventions.
Otolaryngol Head Neck Surg
October 2024
Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Article Synopsis
- Prolonged intubation in neonates, particularly those who are premature or have congenital defects, can lead to serious laryngeal injuries like subglottic stenosis (SGS), but identifying at-risk patients in the NICU is under-researched.
- The study reviewed data from 441 intubated neonates to assess risk factors and interventions related to intubation, discovering that older age at first intubation, recurrent intubations, longer intubation duration, and larger tube sizes increased the likelihood of requiring advanced procedures like direct laryngoscopy (DLB) or tracheostomy.
- Results indicated that 21% of patients underwent DLB, with a
The safety and effectiveness of the treatment of refractory post-intubation subglottic stenosis using short bronchial Dumon stent: a pilot study.
J Thorac Dis
August 2024
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Background: Post-intubation subglottic stenosis (PI-SGS) is a fatal disease which could result in partial or complete narrowing of the airway. Although airway stenting is commonly used as an alternative treatment for PI-SGS patients unsuitable for surgery, complications including stent migration and excessive granulation tissue formation are frequently encountered. Additionally, tracheotomy is necessary in patients undergoing T-tube placement.
View Article and Find Full Text PDFUtilizing ultrasonography to determine the minimal transverse diameter of the subglottic airway for informed selection of reinforced cuffed endotracheal tube models in children.
Eur Arch Otorhinolaryngol
December 2024
Anesthesiology Department, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, No. 289 of Kuocang Road, Liandu District, Lishui, Zhejiang, 323000, People's Republic of China.
Objective: We explored the use of ultrasonography in determining the minimal transverse diameter of the subglottic airway (MTDSA) for the purpose of choosing an appropriate model of reinforced cuffed endotracheal tube.
Methods: A total of 110 pediatric patients who received general anesthesia and tracheal intubation for selective surgeries at the hospital from February 2019 to February 2022 were chosen. They were then randomly assigned to three groups: 39 in the MTDSA group, 35 in the age formula group, and 36 in the height formula group.
[Balloon dilatation of subglottic stenoses, especially in granulomatosis with polyangiitis].
Laryngorhinootologie
July 2024
Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany.
Introduction: Subglottic stenoses (SGS) are constrictions in the region below the vocal folds, that can pose a life-threatening problem for those affected. The aim of this research project was to identify the patient group for which the treatment of SGS by balloon dilatation can lead to long-term success.
Methods: 14 patients with SGS were examined (before and up to12 months after intervention) using pulmonary function tests, laryngoscopies and two questionnaires (Clinical Chronic Obstructive Pulmonary Disease Questionnaire), (modified Medical Research Council Dyspnoea Scale) regarding the respiratory situation.
Airway management of a patient with Mounier-Kuhn syndrome during general anesthesia - A case report.
Anesth Pain Med (Seoul)
April 2024
Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
Background: Mounier-Kuhn syndrome (MKS) is a rare disorder characterized by abnormal dilation of the trachea and main bronchi. MKS can be easily missed on chest X-rays, making diagnosis difficult. Under general anesthesia, challenges such as airway leakage or collapse during mechanical ventilation may complicate the achievement of adequate tidal volumes.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!