Eipe Naveen, Barrowman Nicholas, Writer Hilary, Doherty Dermot
Department of Anesthesiology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Paediatr Anaesth. 2009 Apr;19(4):343-8. doi: 10.1111/j.1460-9592.2008.02916.x. Epub 2009 Jan 21.
Age (in years) of the child has conventionally been used in formulae to estimate the tracheal tube (TT) size. The objective of this retrospective study was to test a weight-based formula (WBF) for uncuffed oral TT in children and compare it with the conventional age-based formula (ABF).
The patient's age, weight, and size of TT internal diameter (ID) were recorded. For comparative analysis, the actual TT size used was compared with predicted TT size, calculated using both the standard ABF [ID = age (years)/4 + 4 mm] and the WBF [ID = weight (kg)/10 + 3.5 mm].
The Pearson's correlation coefficient for age and actual TT size used was 0.77 (95% CI: 0.74-0.80) and between weight and actual TT used was 0.70 (95% CI: 0.66-0.74). The ABF correctly predicted 51.3% of TT sizes while the WBF correctly predicted 44.8% of TT sizes (P = 0.01). The measures of agreement between the actual and predicted TT size were 0.35 and 0.27 for the ABF and WBF respectively. The difference between the percentages of paired predictions for the ABF and WBF was statistically significant (P < 0.001) suggesting that, when correctly predicting the actual tube size used, the WBF functions for a different subset of the patient cohort than the ABF.
This study suggests that in this patient cohort, the WBF is statistically inferior to the conventional ABF. However, our findings also suggest that the WBF may correctly predict TT sizes in a subset of patients in whom the ABF is inaccurate.
传统上,儿童年龄(以岁为单位)被用于公式中以估计气管导管(TT)尺寸。这项回顾性研究的目的是测试一种基于体重的公式(WBF)用于儿童无套囊口腔TT,并将其与传统的基于年龄的公式(ABF)进行比较。
记录患者的年龄、体重和TT内径(ID)尺寸。为了进行比较分析,将实际使用的TT尺寸与使用标准ABF [ID = 年龄(岁)/4 + 4毫米]和WBF [ID = 体重(千克)/10 + 3.5毫米]计算出的预测TT尺寸进行比较。
年龄与实际使用的TT尺寸之间的Pearson相关系数为0.77(95%CI:0.74 - 0.80),体重与实际使用的TT尺寸之间的相关系数为0.70(95%CI:0.66 - 0.74)。ABF正确预测了51.3%的TT尺寸,而WBF正确预测了44.8%的TT尺寸(P = 0.01)。ABF和WBF实际与预测TT尺寸之间的一致性度量分别为0.35和0.27。ABF和WBF配对预测百分比之间的差异具有统计学意义(P < 0.001),这表明在正确预测实际使用的导管尺寸时,WBF适用于与ABF不同的患者亚组。
这项研究表明,在该患者队列中,WBF在统计学上不如传统的ABF。然而,我们的研究结果也表明,WBF可能在ABF不准确的一部分患者中正确预测TT尺寸。