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- Title
Predicting endotracheal tube size in paediatric patients by predicting subglottic diameter using ultrasonographic measurement versus age-based formula.
- Authors
Yadav, Asha; Meena, Jeetendra; Kanwar, Santosh; Jakhar, Sourabh; Sharma, U. D.; Ladla, Manisha
- Abstract
Background: Assessing the paediatric airway poses significant challenges for anaesthesiologists. However, recent advances in ultrasonography offer promise for more precise evaluations. This study aims to compare the externally calculated diameters of endotracheal tubes using traditional formulas based on physical indices with those determined using ultrasound. Materials and Methods: This prospective study conducted at Jodhpur hospitals from September to December 2022 included children under six years undergoing elective surgery with general anesthesia. Clearance was obtained from the Institutional Ethical Committee, and informed consent was secured. Ultrasound measured subglottic diameter, and ETT sizing was assessed using both ultrasound and age-based formula. Statistical analysis involved calculating mean and standard deviations, intra-class correlation (ICC), and McNemar's test for comparison of proportions. Result: Sixty-six children aged 4 days to 72 months were included. Agewise distribution revealed varying proportions across different age groups, with a mean age of 30.30 months. Gender distribution showed 75.76% boys and 24.24% girls. Weight-wise, most children (54%) fell in the 10.1-15 kg range. Height-wise, the majority (31%) were between 91-100 cm. ASA grades 1 and 2 constituted 75.76% and 24.24%, respectively. Agreement analysis indicated that ultrasound-guided ETT sizing matched clinically used sizes in 45.45% of cases, while age-based formulas matched in 13.64%. Comparison between methods showed statistically significant differences (p < 0.001), favoring ultrasound. Intraclass correlation coefficient (ICC) supported the superior reliability of ultrasound (ICC = 0.902) over age-based formulas (ICC = 0.841). Conclusion: Ultrasound-guided endotracheal tube (ETT) sizing demonstrated superior accuracy compared to age-based formulas in paediatric patients undergoing anaesthesia. This study underscores the importance of incorporating ultrasound as a reliable tool for ETT sizing, leading to improved patient safety and outcomes in paediatric anaesthesia practice.
- Subjects
JODHPUR (India); CHILD patients; ENDOTRACHEAL tubes; ELECTIVE surgery; INTRACLASS correlation; SURGERY; AGE groups
- Publication
European Journal of Cardiovascular Medicine, 2024, Vol 14, Issue 2, p345
- ISSN
2042-4884
- Publication type
Article