Zhou Qing-he, Xiao Wang-pin, Zhou Hong-mei
Department of Anesthesia, Second Affiliated Hospital, School of Medicine, Jiaxing University, Jiaxing, China.
Paediatr Anaesth. 2015 Nov;25(11):1132-8. doi: 10.1111/pan.12730. Epub 2015 Aug 4.
It is challenging for anesthetists to determine the optimal tracheal intubation depth in children. We hypothesize that a measure three times the length of the middle finger can be used for predicting tracheal tube depth in children.
Eighty-six children (4-14 years of age) were included in this study. After the children were anesthetized, a fiberoptic bronchoscope (FOB) was inserted into the trachea, the lengths from the upper incisor teeth to carina and vocal cords were measured, and a suitably sized cuffed tracheal tube was inserted into the trachea. Age-based and middle finger length-based formulas were used to determine the tracheal intubation depth.
All 86 children enrolled were included in this study. Compared with the age-based intubation, the rate of appropriate tube placement was higher for middle finger length-based intubation (88.37% vs 66.28%, P = 0.001). The proximal intubation rate was lower in middle finger length-based intubation (4.65% vs 32.56%, P < 0.001). There was only weak evidence for a difference in the distal intubation rate between the two methods (6.97% vs 1.16%, P = 0.054). The correlation coefficient between middle finger length and optimal tracheal tube depth was larger than that between age and optimal tracheal tube depth (0.883 vs 0.845).
Our data indicate that the appropriate tube placement rate can be improved by using three times the middle finger length as the tracheal intubation depth in children.
麻醉医生要确定儿童气管插管的最佳深度具有挑战性。我们假设，中指长度的三倍可用于预测儿童气管导管深度。
本研究纳入了86名4至14岁的儿童。在儿童麻醉后，将纤维支气管镜插入气管，测量从上门齿到隆突和声门的长度，然后将尺寸合适的带套囊气管导管插入气管。使用基于年龄和基于中指长度的公式来确定气管插管深度。
本研究纳入了所有86名登记儿童。与基于年龄的插管相比，基于中指长度的插管合适导管置入率更高（88.37%对66.28%，P = 0.001）。基于中指长度的插管近端插管率更低（4.65%对32.56%，P < 0.001）。两种方法之间远端插管率差异仅有微弱证据（6.97%对1.16%，P = 0.054）。中指长度与最佳气管导管深度之间的相关系数大于年龄与最佳气管导管深度之间的相关系数（0.883对0.845）。
我们的数据表明，在儿童中使用中指长度的三倍作为气管插管深度可提高合适导管置入率。
