scholarly journals Uncuffed Endotracheal Tube Experience in Pediatric Patients with Laparotomy and Laparoscopic Surgeries

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sema Şanal Baş ◽  
Gülay Erdoğan Kayhan ◽  
Meryem Onay ◽  
Yeliz Kılıç
Keyword(s):  
Mechanical Ventilation ◽  
Side Effects ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Pediatric Patients ◽  
Mechanical Parameters ◽  
Significant Difference ◽  
Tube Exchange ◽  
Endotracheal Tube Size ◽  
Selection Of

Aim. The aim of this study is to compare endotracheal tube leak, tube selection, mechanical ventilation, and side effects in the use of uncuffed tubes in both laparoscopic and laparotomy surgeries in pediatric patients. Material and Method. Patients who underwent laparotomy (LT group) or laparoscopic (LS group) surgery between 1 and 60 months. In the selection of uncuffed tubes, it was also planned to start endotracheal intubation with the largest uncuffed tube and to start intubation with a small uncuffed tube if the tube encounters resistance and does not pass. Mechanical parameters, endotracheal tube size, tube changes, and side effects are recorded. Results. A total of 102 patients, 38 females and 64 males, with a mean age of 10.9±8.1 months, body weight 7.1±3.7 kg, and height 67±15 cm, were included. 54 patients underwent laparoscopic surgery, and 48 patients underwent laparotomy. Tube exchange was performed in a total of 18 patients. In patients who underwent tube exchange, 11 patients were intubated with a smaller ETT number and others endotracheal intubation; when the MV parameters were TVe<8 ml/kg and ETT leak>20%, a larger uncuffed tube was used due to PIP 30 cmH2O pressure. Patients with aspiration were not found in the LT and LS groups. There was no difference in the intergroup evaluation for postoperative side effects such as cough, laryngospasm, stridor, and aspiration. Conclusion. There was no significant difference between the groups in terms of tube changes and side effects. So that we can start with the largest possible uncuffed tube to decrease ETT leak, both laparotomy and laparoscopic operations in children can be achieved with safe mechanical ventilation and target tidal volume.

scholarly journals Prediction of Pediatric Endotracheal Tube Size by Ultrasonography

2010 ◽  
Vol 113 (4) ◽  
pp. 819-824 ◽  
Author(s):  
Masayuki Shibasaki ◽  
Yasufumi Nakajima ◽  
Sachiyo Ishii ◽  
Fumihiro Shimizu ◽  
Nobuaki Shime ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Pediatric Patients ◽  
Upper Airway ◽  
Regression Equation ◽  
Outer Diameter ◽  
Highly Correlated ◽  
Development And Validation ◽  
Endotracheal Tube Size ◽  
Development Group ◽  
Selection Of

Background Formulas based on age and height often fail to reliably predict the proper endotracheal tube (ETT) size in pediatric patients. We, thus, tested the hypothesis that subglottic diameter, as determined by ultrasonography, better predicts optimal ETT size than existing methods. Methods A total of 192 patients, aged 1 month to 6 yr, who were scheduled for surgery and undergoing general anesthesia were enrolled and divided into development and validation phases. In the development group, the optimal ETT size was selected according to standard age-based formulas for cuffed and uncuffed tubes. Tubes were replaced as necessary until a good clinical fit was obtained. Via ultrasonography, the subglottic upper airway diameter was determined before tracheal intubation. We constructed a regression equation between the subglottic upper airway diameter and the outer diameter of the ETT finally selected. In the validation group, ETT size was selected after ultrasonography using this regression equation. The primary outcome was the fraction of initial cuffed and uncuffed tube sizes, as selected through the regression formula, that proved clinically optimal. Results Subglottic upper airway diameter was highly correlated with outer ETT diameter deemed optimal on clinical grounds. The rate of agreement between the predicted ETT size based on ultrasonic measurement and the final ETT size selected clinically was 98% for cuffed ETTs and 96% for uncuffed ETTs. Conclusions Measuring subglottic airway diameter with ultrasonography facilitates the selection of appropriately sized ETTs in pediatric patients. This selection method better predicted optimal outer ETT diameter than standard age- and height-based formulas.

scholarly journals Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter

2021 ◽  
Author(s):  
Demet Altun ◽  
Can Doruk ◽  
Müşerref Beril Dinçer ◽  
Meltem Merve Güler
Keyword(s):  
Endotracheal Tube ◽  
Distal Radius ◽  
Pediatric Patients ◽  
Outer Diameter ◽  
Transverse Diameter ◽  
Tube Size ◽  
The Us ◽  
Tube Exchange ◽  
Best Fit ◽  
Endotracheal Tube Size

INTRODUCTION: The aim of this study is to test the usefulness of epiphysis of distal radius measurement as a surrogate parameter for endotracheal tube (ETT) size prediction in children. METHODS: Seventy-three children were intubated with cuffed ETT selected according to age-based formula. Transvers diameter of epiphysis of distal radius and subglottic diameter of trachea were measured by ultrasound (US). Correlation between the outer diameter of best-fit endotracheal tube and transvers diameter of both radius epiphysis and subglottic diameter were calculated. The need for tube exchange, time for ultrasound (US) measurements and the ease level of measurements were compared. RESULTS: First attempt success at intubation was 83.6%. The correlation of the epiphysis diameter of the distal radius and best-fit ETT was significant (p<0.001, r= 0.619, r2=0.383, 95% CI=0.419-0.838). Similarly the correlation of subglottic tracheal diameter and best-fit ETT was significant (p<0.001, r=0.744, r2=0.553, 95% CI=0.678-825). Estimated ETT sizes according to radial epiphysis diameter and subglottic diameter were optimal in 82.2% and 94.5% respectively. Time for the US measurements of radial epiphysis and subglottic area were 38.3±9.6 and 24.9±4.6 seconds respectively (p<0.001). The level of ease of US measurements were rated for radial epiphysis as 6 (5-9) and for subglottic area as 8 (7-9) (p<0.001). DISCUSSION AND CONCLUSION: US measured transverse diameter of distal radius epiphysis resulted in similar success rate to age-based formula in our child population. Subglottic diameter measured by US estimates ETT size more accurately; it is also less time consuming and easier.

scholarly journals Measurement of the Endotracheal Tube Diameter Using Computed Tomography Images for Pediatric Patients: Comparison with Classic Formulas

2021 ◽  
Author(s):  
Hatice Dilek Özcanoğlu ◽  
Berna Türkay ◽  
Neşe Kutlutürk Şahin ◽  
Zahide Özlem Ulubay ◽  
Ayşe Sevinç Revanlı ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Endotracheal Tube ◽  
Congenital Heart ◽  
Pediatric Patients ◽  
Transverse Diameter ◽  
External Diameter ◽  
Old Patients ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
The Mean

Objective: In this retrospective study, we aimed to evaluate the compatibility of endotracheal tube (ETT) size used during surgery with tracheal diameter measured by computed tomography(CT) and classic formulas in children who underwent CT imaging preoperatively due to surgical indications. Methods: The study included preoperatively CT scanned, 0-3 year-old patients who were operated due to congenital heart diseases between June 1-October 1, 2018.Using the CT scans, transverse and anteroposterior tracheal diameters were measured from the subglottic level. As these diameters reflect the external diameter of the ETT, the inner diameter-which corresponds the ETT size-was calculated using a correction formula. Besides, Cole’s formula was used to calculate the ETT size for each child, and the tube sizes used during surgeries were obtained from anesthesia charts.ETT sizes were compared. Results: 43 patients (22 girls [51.2%],21 boys [48.8%]) were included.The mean age was 10.5±9.6 months. 18 patients (41.9%) had cyanotic, 25 patients (58.1%) had acyanotic heart disease.Mean corrected transverse and anteroposterior tracheal diameters at CT images were 4.35±0.69mm and 4.30±0.71 mm, respectively. The mean diameter calculated by Cole’s formula was 4.22±0.20 mm. The mean tube size used during surgeries was 4.37±0.60 mm. There was no statistically significant difference between the tube sizes used during the surgeries and the corrected transverse tracheal diameters from CT measurements (p>0.05). But the tube sizes used during the surgeries found significantly larger than the diameters obtained by Cole’s formula (p<0.05). Conclusion: In 0-3 years of age pediatric patients who undergo a congenital heart surgery,corrected tracheal transverse diameter measured by CT is more effective,reliable and less invasive than classic formulas for determining appropriate ETT size

Antibacterial Properties and Application of Nanosilver Material in the Tracheal Tube

2020 ◽  
Vol 20 (10) ◽  
pp. 6542-6546
Author(s):  
Yunjie Hu ◽  
Xiaobei Ji ◽  
Dunshuang Wei ◽  
Jun Deng
Keyword(s):  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Tracheal Tube ◽  
Antibacterial Properties ◽  
Plate Count ◽  
Control Group ◽  
Significant Difference ◽  
New Type ◽  
Experimental Group

To investigate the antibacterial ability of a new type of antibacterial tracheal tube coated with nanosilver/polyurethane in rats. In January 2016, 48 male SD rats of SPF grade, provided by the medical center of Hong Kong University of science and technology, Peking University, Shenzhen, were selected as the study objects. Twenty-four healthy rats, who underwent endotracheal intubation and retained nanosilver/polyurethane-coated new antibacterial endotracheal tube in vivo, were randomly selected as the experimental group, while 24 healthy rats who underwent endotracheal intubation at the same time and retained common endotracheal tube in vivo were randomly selected as the control group. At 12, 24, 48, and 72 hours after the operation, the number of colonies in the alveolar lavage fluid of the two groups was measured using the plate count method, and the thickness of the biofilm formed by the built-in catheter of the two groups was observed by microscope. Twelve hours after operation, there was no significant difference between the two groups (P <0.05). The colony number in BALF in the experimental group was significantly lower than that in the control group (P < 0.05). At 12 and 24 hours after operation, there was no significant difference in the biofilm thickness between the two groups (P > 0.05). In the experimental group, the thickness of biofilm that had formed by catheterization 48 and 72 hours after operation was significantly lower than that in the control group (P < 0.05). The new type of antibacterial tracheal tube, coated with nanosilver/polyurethane, has stronger antibacterial and anti-biofilm proliferation performance than that of the common tracheal tube.

scholarly journals Prediction of endotracheal tube size for pediatric patients from the epiphysis diameter of radius

2017 ◽  
Vol 70 (1) ◽  
pp. 52 ◽  
Author(s):  
Hee Young Kim ◽  
Ji Hyun Cheon ◽  
Seung Hoon Baek ◽  
Kyung Hoon Kim ◽  
Tae Kyun Kim
Keyword(s):  
Endotracheal Tube ◽  
Pediatric Patients ◽  
Tube Size ◽  
Endotracheal Tube Size

Selection of appropriate endotracheal tube size using thoracic radiography in Beagle dogs

2018 ◽  
Vol 45 (1) ◽  
pp. 13-21 ◽  
Author(s):  
Chi Won Shin ◽  
Won-gyun Son ◽  
Min Jang ◽  
Hyunseok Kim ◽  
Hyungjoo Han ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Beagle Dogs ◽  
Thoracic Radiography ◽  
Tube Size ◽  
Endotracheal Tube Size ◽  
Selection Of
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