TY  - JOUR
TI  - Selecting an Appropriate Cuffed Endotracheal Tube Using Ultrasound of the Cricoid in a Child with Down Syndrome
AB  - 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.
AU  - KAYASHİMA, Kenji
AU  - YAMASAKI, Ryo
DO  - 10.5152/TJAR.2018.87847
PY  - 2018
JO  - Turkish Journal of Anaesthesiology and Reanimation
VL  - 46
IS  - 4
SN  - 2667-677X
SP  - 323
EP  - 325
DB  - TRDizin
UR  - http://search/yayin/detay/307964
ER  -