Ultrasonographic Estimation of Endotracheal Case Series Tube Size in Paediatric Patients and its Comparison with Physical Indices Based Formulae: A Prospective Study
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 5
Abstract
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.
Authors and Affiliations
Jagadish G Sutagatti, Ranjana Raja, Madhuri S Kurdi
Primary Epidural Intraspinal Haemangiopericytoma
ABSTRACT Here, authors present a case report of a 25-year-old male who reported with low back pain with left lower limb radiculopathy for two years. Neurological examination revealed no focal neurological deficits, excep...
Apical Extrusion of Debris in Mesiobuccal Root of Maxillary Molars with Five Rotary File Systems
ABSTRACT Introduction: Flare-ups in endodontics are multifactorial and may cause severe discomfort to the patient. Apical extrusion while preparing root canal space in any form such as debris, bacteria or irrigants has b...
Economic Analysis of Type-2 Diabetes Mellitus in Vietnam: A Retrospective Study at a District Hospital, Ba Ria-Vung Tau Province
ABSTRACT Introduction: In Vietnam, despite the major health concerns of type-2 Diabetes Mellitus (T2DM), comprehensive information on its economic costs is lacking. Aim: To evaluate the economic burden caused by diabetic...
Analysis of Xenobiotics Biotransformation and DNA Repair Genes as Factors of Aetiology, Pathogenesis and Criteria of Progression in Children with Congenital Spine Deformities
ABSTRACT Introduction: Spine congenital curvatures formed as a result of anomalies in the development of vertebral bodies leads to severe and rigid deformities of the spinal column in the adolescent age and are often acc...
Review of Ayuvedic Strategies to Overcome Nidranasha and Improve Quality of Life
ABSTRACT Introduction: Insomnia is the most commonly reported sleep problem, which profoundly affects the person’s quality of life. In Ayurveda various non-pharmacological methods related with dietary modifications, phys...