Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter

Altun, Demet; dincer, müserref beril; Doruk, Can; GÜLER, MELTEM MERVE; altun, dilek; Çamcı, Emre

doi:10.5222/jarss.2021.44366

Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter

Demet Altun, (İstanbul Üniversitesi İstanbul Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye)

Can Doruk, (İstanbul Üniversitesi İstanbul Tıp Fakültesi Kulak Burun Boğaz Anabilim Dalı, İstanbul, Türkiye)

Müserref Beril Dincer, (stanbul Üniversitesi İstanbul Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye)

Meltem Merve Güler, (İstanbul Üniversitesi İstanbul Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye)

Dilek Altun, (Bakırköy Acıbadem Hastanesi Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye)

Emre Çamcı (İstanbul Üniversitesi İstanbul Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye)

Anestezi Dergisi

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Yıl: 2021 Cilt: 29 Sayı: 2 Sayfa Aralığı: 119 - 124 Metin Dili: İngilizce DOI: 10.5222/jarss.2021.44366 İndeks Tarihi: 29-12-2021

Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter

Öz:

Objective: The aim of this study is to test the usefulness of epiphysis of distal radius measurement as a surrogate parameter for endotracheal tube (ETT) size prediction in children. Methods: Seventy-three children were intubated with cuffed ETT selected according to age-based formula. Transvers diameter of epiphysis of distal radius and subglottic diameter of trachea were measured by ultrasound (USG). Correlation between the outer diameter of best-fit endotracheal tube and transvers diameter of both radius epiphysis and subglottic diameter were calculated. The need for tube exchange, time for USG measurements and the ease level of measurements were compared. Results: First attempt success at intubation was 83.6%. The correlation of the epiphysis diameter of the distal radius and best-fit ETT was significant (p<0.001, r=0.619, r2=0.383, 95% CI=0.419- 0.838). Similarly the correlation of subglottic tracheal diameter and best-fit ETT was significant (p<0.001, r=0.744, r2=0.553, 95% CI=0.678-825). Estimated ETT sizes according to radial epiphysis diameter and subglottic diameter were optimal in 82.2% and 94.5% respectively. Time for the USG measurements of radial epiphysis and subglottic area were 38.3±9.6 and 24.9±4.6 seconds respectively (p<0.001). The level of ease of USG measurements were rated for radial epiphysis as 6 (5-9) and for subglottic area as 8 (7-9) (p<0.001). Conclusion: USG measured transverse diameter of distal radius epiphysis resulted in similar suc- cess rate to age-based formula in our child population. Subglottic diameter measured by USG estimates ETT size more accurately; it is also less time consuming and easie

Anahtar Kelime:

Pediyatrik Hastalarda Uygun Endotrakeal Tüp Çapının Belirlenmesi: Distal Radius Epifiz Çapının ve Subglottik Çapın Kullanımı

Öz:

Amaç: Bu çalışmanın amacı, çocuklarda endotrakeal tüp (ETT) çapının belirlenmesinde yedek parametre olarak distal radius epifiz ölçümünün yararlılığını test etmektir. Yöntem: Yetmiş üç çocuk, yaşa dayalı formüle göre seçilen kafli ETT ile entübe edildi. Distal radius epifizinin transvers çapı ve trakeanın subglotik çapı ultrason (USG) ile ölçüldü. En uygun endotra- keal tüpün iç çapı ile hem radius epifizi hem de subglottik çapın transvers çapı arasındaki ilişki hesaplandı. Tüp değiştirme ihtiyacı, USG ölçümleri için zaman ve ölçümlerin kolaylık düzeyi karşı- laştırıldı. Bulgular: Entübasyonda ilk girişim başarısı %83.6 idi. Distal radiusun epifiz çapı ile en iyi uyan ETT arasındaki korelasyon anlamlıydı (p<0.001, r=0.619, r2=0.383, 95% CI=0.419-0.838). Benzer şekil- de, subglottik trakeal çap ile en iyi uygun ETT arasındaki korelasyon anlamlıydı (p<0.001, r=0.744, r2=0.553, 95% CI=0.678-825). Radyal epifiz çapına ve subglottik çapa göre tahmini ETT çapları sırasıyla %82.2 ve %94.5. Radyal epifiz ve subglottik alanın ultrason ile ölçümleri için süre sırasıy- la 38.3±9.6 ve 24.9±4.6 saniye idi (p<0.001). Ultrason ölçümlerinin kolaylık düzeyi radyal epifiz için 6 (5-9) ve subglottik alan için 8 (7-9) olarak derecelendirildi (p<0.001). Sonuç: Ultrason ile ölçülen distal radius epifizinin transvers çapı, çocuk popülasyonumuzda yaşa dayalı formülle benzer başarı oranıyla sonuçlandı. USG ile ölçülen subglottik çap, ETT çapını daha doğru tahmin eder; aynı zamanda daha az zaman alır ve daha kolayd

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Altun D, Doruk C, dincer m, GÜLER M, altun d, Çamcı E (2021). Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter. , 119 - 124. 10.5222/jarss.2021.44366
Chicago	Altun Demet,Doruk Can,dincer müserref beril,GÜLER MELTEM MERVE,altun dilek,Çamcı Emre Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter. (2021): 119 - 124. 10.5222/jarss.2021.44366
MLA	Altun Demet,Doruk Can,dincer müserref beril,GÜLER MELTEM MERVE,altun dilek,Çamcı Emre Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter. , 2021, ss.119 - 124. 10.5222/jarss.2021.44366
AMA	Altun D,Doruk C,dincer m,GÜLER M,altun d,Çamcı E Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter. . 2021; 119 - 124. 10.5222/jarss.2021.44366
Vancouver	Altun D,Doruk C,dincer m,GÜLER M,altun d,Çamcı E Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter. . 2021; 119 - 124. 10.5222/jarss.2021.44366
IEEE	Altun D,Doruk C,dincer m,GÜLER M,altun d,Çamcı E "Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter." , ss.119 - 124, 2021. 10.5222/jarss.2021.44366
ISNAD	Altun, Demet vd. "Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter". (2021), 119-124. https://doi.org/10.5222/jarss.2021.44366

APA	Altun D, Doruk C, dincer m, GÜLER M, altun d, Çamcı E (2021). Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter. Anestezi Dergisi, 29(2), 119 - 124. 10.5222/jarss.2021.44366
Chicago	Altun Demet,Doruk Can,dincer müserref beril,GÜLER MELTEM MERVE,altun dilek,Çamcı Emre Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter. Anestezi Dergisi 29, no.2 (2021): 119 - 124. 10.5222/jarss.2021.44366
MLA	Altun Demet,Doruk Can,dincer müserref beril,GÜLER MELTEM MERVE,altun dilek,Çamcı Emre Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter. Anestezi Dergisi, vol.29, no.2, 2021, ss.119 - 124. 10.5222/jarss.2021.44366
AMA	Altun D,Doruk C,dincer m,GÜLER M,altun d,Çamcı E Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter. Anestezi Dergisi. 2021; 29(2): 119 - 124. 10.5222/jarss.2021.44366
Vancouver	Altun D,Doruk C,dincer m,GÜLER M,altun d,Çamcı E Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter. Anestezi Dergisi. 2021; 29(2): 119 - 124. 10.5222/jarss.2021.44366
IEEE	Altun D,Doruk C,dincer m,GÜLER M,altun d,Çamcı E "Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter." Anestezi Dergisi, 29, ss.119 - 124, 2021. 10.5222/jarss.2021.44366
ISNAD	Altun, Demet vd. "Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter". Anestezi Dergisi 29/2 (2021), 119-124. https://doi.org/10.5222/jarss.2021.44366