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Intubation depth markings allow an improved positioning of endotracheal tubes in children


Weiss, Markus; Balmer, Christian; Dullenkopf, Alexander; Knirsch, Walter; Gerber, Andreas C; Bauersfeld, Urs; Berger, Felix (2005). Intubation depth markings allow an improved positioning of endotracheal tubes in children. Canadian Journal of Anaesthesia = Journal Canadien d'Anesthésie, 52(7):721-726.

Abstract

Objectives: To evaluate the position of the new Microcuff® pediatric tracheal tube, based upon intubation depth markings. Methods: With Institutional Ethics Committee approval and informed parental consent, we included patients from birth (≥ 3 kg) to 16 yr undergoing interventional cardiac catheterization requiring general anesthesia with oro-tracheal intubation. The intubation depth mark of the tracheal tube was placed between the vocal cords by direct laryngoscopy. The distance between tube tip and tracheal carina was measured from routinely taken cardiac catheterization posterior-anteriorx-ray computer images with the patient supine and the head in a neutral position. Evaluation was performed for 20 tubes size 3.0 mm internal diameter (ID) and for ten tubes of each size from 3.5 to 7.0 mm ID. Results: 100 patients were studied (47 girls; 53 boys). Tracheal tube tip advancement into the trachea ranged from 40.6% to 68.6% (median 51.4%). The shortest distance from tube tip to the tracheal carina was 15.7 mm using a 3.0 mm ID tube. Using a standard formula for tube insertion in children aged ≥ two years [12 cm + (age/2)], in one patient the tube tip would have been below the carina and in seven patients the tube cuffs would have been placed within the larynx. Conclusion: The intubation depth markings of the new Microcuff® pediatric tracheal tube allow safe placement of the tracheal tube with a cuff-free laryngeal zone without the risk for endobronchial intubation. Placement using the intubation depth markings was superior to predicted insertion using a standard formula

Abstract

Objectives: To evaluate the position of the new Microcuff® pediatric tracheal tube, based upon intubation depth markings. Methods: With Institutional Ethics Committee approval and informed parental consent, we included patients from birth (≥ 3 kg) to 16 yr undergoing interventional cardiac catheterization requiring general anesthesia with oro-tracheal intubation. The intubation depth mark of the tracheal tube was placed between the vocal cords by direct laryngoscopy. The distance between tube tip and tracheal carina was measured from routinely taken cardiac catheterization posterior-anteriorx-ray computer images with the patient supine and the head in a neutral position. Evaluation was performed for 20 tubes size 3.0 mm internal diameter (ID) and for ten tubes of each size from 3.5 to 7.0 mm ID. Results: 100 patients were studied (47 girls; 53 boys). Tracheal tube tip advancement into the trachea ranged from 40.6% to 68.6% (median 51.4%). The shortest distance from tube tip to the tracheal carina was 15.7 mm using a 3.0 mm ID tube. Using a standard formula for tube insertion in children aged ≥ two years [12 cm + (age/2)], in one patient the tube tip would have been below the carina and in seven patients the tube cuffs would have been placed within the larynx. Conclusion: The intubation depth markings of the new Microcuff® pediatric tracheal tube allow safe placement of the tracheal tube with a cuff-free laryngeal zone without the risk for endobronchial intubation. Placement using the intubation depth markings was superior to predicted insertion using a standard formula

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Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Anesthesiology and Pain Medicine
Language:English
Date:1 August 2005
Deposited On:23 Oct 2018 14:27
Last Modified:29 Apr 2021 17:18
Publisher:Springer
ISSN:0832-610X
OA Status:Hybrid
Publisher DOI:https://doi.org/10.1007/bf03016560

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