Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome
Yıl: 2018 Cilt: 46 Sayı: 4 Sayfa Aralığı: 323 - 325 Metin Dili: İngilizce DOI: 10.5152/TJAR.2018.87847 İndeks Tarihi: 24-09-2019
Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome
Öz: A 7-year-old girl (height, 94 cm; weight, 15.1 kg) with Downsyndrome was scheduled for right patellar dislocation repositioning.The ultrasonographically measured internal transverse widthof the cricoid before intubation was 7.8 mm. Attempted insertionof a cuffed Mallinckrodt® endotracheal tube (ETT) (internal diameter,5.0 mm; deflated cuff portion, 8.4 mm diameter) failed.In contrast, the insertion of a cuffed Microcuff® ETT (5.0 mm ID;deflated cuff portion, 7.3 mm diameter) was successful. Thickerfolds in the deflated cuff of the Mallinckrodt ETT could havehindered passage through the vocal cord, including the cricoidregion. It is becoming standard to use the ultrasonographicallymeasured internal width of the cricoid when choosing cuffed paediatricETTs, and this approach may be suitable for patients withDown syndrome as well. In these children, approximately 20%of uncuffed ETTs inserted were one or two sizes smaller in diameterthan those predicted for the same age. We may choose theETT size in reference to an ultrasonographically obtained internaltransverse width of the cricoid, stated outer diameter (OD) by theproducer, and the actual OD depending on the cuff bulk insteadof a tube size calculation in patients with growth retardation.
Anahtar Kelime: Konular:
Down Sendromu Olan Bir Çocukta Krikoid Ultrasonu Kullanılarak Uygun Bir Kaflı Endotrakeal Tüpün Seçilmesi
Öz: Yedi yaşındaki (boy: 94 cm, ağırlık: 15,1 kg) Down sendromlu bir kız çocuğu için, sağ patellar dislokasyon repozisyonu planlandı. Entübasyon öncesinde ultrasonografik olarak ölçülen internal transvers krikoid genişliği 7,8 mm idi. Kaflı Mallinckrodt® endotrakeal tüp (ETT) (iç çap, 5,0 mm; sönük kaf çapı 8,4 mm) uygulama denemesi başarısız oldu. Ancak, kaflı Microcuff® ETT (5,0 mm iç çap; sönük kaf çapı, 7,3 mm) başarıyla yerleştirildi. Mallinckrodt ETT’nin sönük kafındaki daha kalın katlar, krikoid bölgesi de dahil vokal korttan geçişi engellemiş olabilir. Kaflı pediatrik ETT’leri seçerken ultrasonografik olarak ölçülen internal transvers krikoid genişliğinin kullanılması standartlaşmaktadır ve bu yaklaşım Down sendromlu hastalar için de uygun olabilir. Bu çocuklarda yerleştirilen kafsız ETT’lerin yaklaşık %20’si, aynı yaştaki diğer çocuklar için öngörülenlerden, çap olarak bir ya da iki ebat daha küçüktü. Gelişme geriliği olan hastalarda ETT büyüklüğünü ultrasonografik olarak elde edilen internal transvers krikoid genişliği, üretici tarafından belirtilen dış çap (DÇ) ve tüp ebatı hesaplaması yerine kaf kütlesine bağlı olarak gerçek DÇ’a göre seçebiliriz.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık
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| APA | KAYASHİMA K, YAMASAKI R (2018). Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome. , 323 - 325. 10.5152/TJAR.2018.87847 |
| Chicago | KAYASHİMA Kenji,YAMASAKI Ryo Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome. (2018): 323 - 325. 10.5152/TJAR.2018.87847 |
| MLA | KAYASHİMA Kenji,YAMASAKI Ryo Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome. , 2018, ss.323 - 325. 10.5152/TJAR.2018.87847 |
| AMA | KAYASHİMA K,YAMASAKI R Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome. . 2018; 323 - 325. 10.5152/TJAR.2018.87847 |
| Vancouver | KAYASHİMA K,YAMASAKI R Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome. . 2018; 323 - 325. 10.5152/TJAR.2018.87847 |
| IEEE | KAYASHİMA K,YAMASAKI R "Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome." , ss.323 - 325, 2018. 10.5152/TJAR.2018.87847 |
| ISNAD | KAYASHİMA, Kenji - YAMASAKI, Ryo. "Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome". (2018), 323-325. https://doi.org/10.5152/TJAR.2018.87847 |
| APA | KAYASHİMA K, YAMASAKI R (2018). Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome. Turkish Journal of Anaesthesiology and Reanimation, 46(4), 323 - 325. 10.5152/TJAR.2018.87847 |
| Chicago | KAYASHİMA Kenji,YAMASAKI Ryo Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome. Turkish Journal of Anaesthesiology and Reanimation 46, no.4 (2018): 323 - 325. 10.5152/TJAR.2018.87847 |
| MLA | KAYASHİMA Kenji,YAMASAKI Ryo Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome. Turkish Journal of Anaesthesiology and Reanimation, vol.46, no.4, 2018, ss.323 - 325. 10.5152/TJAR.2018.87847 |
| AMA | KAYASHİMA K,YAMASAKI R Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome. Turkish Journal of Anaesthesiology and Reanimation. 2018; 46(4): 323 - 325. 10.5152/TJAR.2018.87847 |
| Vancouver | KAYASHİMA K,YAMASAKI R Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome. Turkish Journal of Anaesthesiology and Reanimation. 2018; 46(4): 323 - 325. 10.5152/TJAR.2018.87847 |
| IEEE | KAYASHİMA K,YAMASAKI R "Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome." Turkish Journal of Anaesthesiology and Reanimation, 46, ss.323 - 325, 2018. 10.5152/TJAR.2018.87847 |
| ISNAD | KAYASHİMA, Kenji - YAMASAKI, Ryo. "Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome". Turkish Journal of Anaesthesiology and Reanimation 46/4 (2018), 323-325. https://doi.org/10.5152/TJAR.2018.87847 |
