Uzumcugil Filiz, Celebioglu Emre Can, Ozkaragoz Demet Basak, Yilbas Aysun Ankay, Akca Basak, Lotfinagsh Nazgol, Celebioglu Bilge
Department of Anesthesiology and Reanimation, Hacettepe University School of Medicine, Ankara, Turkey.
Department of Radiology, Karabük University, Karabük, Turkey.
Clin Exp Otorhinolaryngol. 2018 Dec;11(4):301-308. doi: 10.21053/ceo.2018.00178. Epub 2018 Aug 25.
The age-based Cole formula has been employed for the estimation of endotracheal tube (ETT) size due to its ease of use, but may not appropriately consider growth rates among children. Child growth is assessed by calculating the body surface area (BSA). The association between the outer diameter of an appropriate uncuffed-endotrachealtube (ETT-OD) and the BSA values of patients at 24-96 months of age was our primary outcome.
Cole formula, BSA, age, height, weight and ultrasound measurement of subglottic-transverse-diameter were evaluated for correlations with correct uncuffed ETT-OD. The Cole formula, BSA, and ultrasound measurements were analyzed for estimation rates in all patients and age subgroups. The maximum allowed error for the estimation of ETT-OD was ≤0.3 mm. Patients' tracheas were intubated with tubes chosen by Cole formula and correct ETT-OD values were determined using leak test. ETT exchange rates were recorded.
One-hundred twenty-seven patients were analyzed for the determination of estimation rates. Thirteen patients aged ≥72 months were intubated with cuffed ETT-OD of 8.4 mm and were accepted to need uncuffed ETT-OD >8.4 mm in order to be included in estimation rates, but excluded from correlations for size analysis. One-hundred fourteen patients were analyzed for correlations between correct ETT-OD (determined by the leak test) and outcome parameters. Cole formula, ultrasonography, and BSA had similar correct estimation rates. All three parameters had higher underestimation rates as age increased.
The Cole formula, BSA, and ultrasonography had similar estimation rates in patients aged 24≤ to ≤96 months. BSA had a correct estimation rate of 40.2% and may not be reliable in clinical practice to predict uncuffedETT-size.
基于年龄的科尔公式因其使用简便，已被用于估计气管内插管（ETT）尺寸，但可能未充分考虑儿童的生长速率。儿童生长情况通过计算体表面积（BSA）来评估。本研究的主要结果是24至96月龄患者合适的无套囊气管内插管外径（ETT-OD）与BSA值之间的关联。
评估科尔公式、BSA、年龄、身高、体重以及声门下横径的超声测量值与正确的无套囊ETT-OD之间的相关性。分析科尔公式、BSA和超声测量值在所有患者及年龄亚组中的估计率。ETT-OD估计的最大允许误差≤0.3毫米。使用科尔公式选择的气管插管对患者进行气管插管，并通过漏气试验确定正确的ETT-OD值。记录ETT更换率。
对127例患者进行分析以确定估计率。13例年龄≥72个月的患者使用8.4毫米的带套囊ETT-OD进行气管插管，为纳入估计率分析，这些患者被认为需要无套囊ETT-OD>8.4毫米，但被排除在尺寸分析的相关性研究之外。对114例患者分析正确的ETT-OD（通过漏气试验确定）与结果参数之间的相关性。科尔公式、超声检查和BSA的正确估计率相似。随着年龄增加，所有三个参数的低估率均更高。
科尔公式、BSA和超声检查在24≤至≤96月龄患者中的估计率相似。BSA的正确估计率为40.2%，在临床实践中预测无套囊ETT尺寸可能不可靠。
