Body Surface Area Is Not a Reliable Predictor of Tracheal Tube Size in Children

Filiz Uzumcugil; Emre Can Celebioglu; Demet Basak Ozkaragoz; Aysun Ankay Yilbas; Basak Akca; Nazgol Lotfinagsh; Bilge Celebioglu

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자료유형: 학술저널

저자정보: Filiz Uzumcugil Emre Can Celebioglu Demet Basak Ozkaragoz Aysun Ankay Yilbas Basak Akca Nazgol Lotfinagsh Bilge Celebioglu

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제11권 제4호

발행연도: 2018.1

수록면: 301 - 308 (8page)

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Objectives. The age-based Cole formula has been employed for the estimation of endotracheal tube (ETT) size due to its ease of use, but may not appropriately consider growth rates among children. Child growth is assessed by calculating the body surface area (BSA). The association between the outer diameter of an appropriate uncuffed-endotracheal-tube (ETT-OD) and the BSA values of patients at 24–96 months of age was our primary outcome. Methods. Cole formula, BSA, age, height, weight and ultrasound measurement of subglottic-transverse-diameter were evaluated for correlations with correct uncuffed ETT-OD. The Cole formula, BSA, and ultrasound measurements were analyzed for estimation rates in all patients and age subgroups. The maximum allowed error for the estimation of ETT-OD was ≤0.3 mm. Patients’ tracheas were intubated with tubes chosen by Cole formula and correct ETT-OD values were determined using leak test. ETT exchange rates were recorded. Results. One-hundred twenty-seven patients were analyzed for the determination of estimation rates. Thirteen patients aged ≥72 months were intubated with cuffed ETT-OD of 8.4 mm and were accepted to need uncuffed ETT-OD >8.4 mm in order to be included in estimation rates, but excluded from correlations for size analysis. One-hundred fourteen patients were analyzed for correlations between correct ETT-OD (determined by the leak test) and outcome parameters. Cole formula, ultrasonography, and BSA had similar correct estimation rates. All three parameters had higher underestimation rates as age increased. Conclusion. The Cole formula, BSA, and ultrasonography had similar estimation rates in patients aged ≥24 to ≤96 months. BSA had a correct estimation rate of 40.2% and may not be reliable in clinical practice to predict uncuffed-ETT-size.

참고문헌 (17)

참고문헌 신청

Sirisopana M / 2013 / Novel measurements of the length of the subglottic airway in infants and young children / Anesth Analg 117(2):462~470

Wani TM / 2016 / Age-based analysis of pediatric upper airway dimensions using computed tomography imaging / Pediatr Pulmonol 51(3):267~271

Dalal PG / 2009 / Pediatric laryngeal dimensions: an age-based analysis / Anesth Analg 108(5):1475~1479

Marciniak B / 2013 / A practice of anesthesia for infants and children / Elsevier Saunders :7~21

Schramm C / 2012 / Role of ultrasound compared to age-related formulas for uncuffed endotracheal intubation in a pediatric population / Paediatr Anaesth 22(8):781~786

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