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ORIGINAL ARTICLE
Year : 2022  |  Volume : 24  |  Issue : 3  |  Page : 114-117

Height measurement and ultrasound assessment of subglottic region for the estimation of appropriate endotracheal tube size in pediatric population


1 Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, King Abdulaziz Medical City and King Abdullah Specialist Children's Hospital, National Guard Health Affairs, Riyadh, Saudi Arabia
2 Department of Pediatric Anesthesia, King Abdullah Specialist Children's Hospital, National Guard Health Affairs, Riyadh, Saudi Arabia
3 Departement of Surgery, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

Correspondence Address:
Dr. Salwa AlRashed AlHumaid
Department of Surgery, Division of Otolaryngology and Head and Neck Surgery, King Abdulaziz Medical City and King Abdullah Specialist Children's Hospital, National Guard Health Affairs, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjoh.sjoh_22_22

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Background: Choosing the appropriate endotracheal tube (ETT) size in pediatric patients is crucial to guarantee well ventilation and reliable end-tidal gas monitoring. Different methods have been established for choosing appropriate ETT size with varied validities depending on the demographics of the patients. Objectives: The primary objective is to investigate a relationship between the height of the patient and the appropriate ETT size and form a predictive formula. Design: A prospective, observational study was conducted between November 2019 and March 2020 in a pediatric hospital, Riyadh, Saudi Arabia. Setting: Patients below 14 years of age admitted for elective day surgery with American Society of Anesthesiologist Class 1 or 2 were invited to participate. Patients with anticipated difficult airway or neck mass or those refused to enroll were excluded. Methods: After obtaining institutional review board approval, informed consents were taken from all patients' guardians. Collected data were gathered in excel sheet. Main Outcome Measures: Demographic and clinical data were collected. The subglottic area was measured before induction of anesthesia by bedside ultrasound machine. No formulas were used for ETT size used. Sample Size: 71 children were included in the study. Results: The ETT based on the height of the patient was estimated using the formula below as “estimated ETT size if other formula used:” {INSIDE:1] estimated based on height. Pearson's correlation results revealed a positive association between the ETT used and ETT estimated. The relationship between variables is insignificant, with a P > 0.05. There was an overestimation in both the ETT used and ETT estimated in the stepwise regression analysis. About 88.5% overestimate the ETT used based on age, and about 89.7% overestimate the ETT based on patient height. The F-value change statistics indicates a statistical significance of ETT used and ETT estimated. Conclusion: It is crucial to have an accurate ETT tube size used in children. The height of the child was found to have good correlation with ETT size in our Saudi population. Limitation: Part of the limitations faced was the fact that it was a single-center study which may not represent the population from other areas.


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