Department of Anaesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Seoul, South Korea.
Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Br J Anaesth. 2019 Sep;123(3):309-315. doi: 10.1016/j.bja.2019.03.020. Epub 2019 Apr 12.
The tip of the tracheal tube should lie at the mid-tracheal level after tracheal intubation in paediatric patients. Auscultation does not guarantee optimal positioning of the tracheal tube. We compared auscultation and the ultrasound-guided lung sliding sign to confirm optimal positioning of the tracheal tube in paediatric patients.
We studied 74 paediatric patients aged 0-24 months of ASA physical status 1-3 who were scheduled for elective surgery under general anaesthesia. All were randomly assigned to one of two groups: depth of tracheal tube confirmed by auscultation (Group A) or using the ultrasound-guided lung sliding sign (Group S).
Optimal positioning of the tracheal tube was observed in 32 of 37 (87%) subjects in Group S and 24 of 37 (65%) subjects in Group A (difference in proportion, 22%; 95% confidence interval, 2-39%; P=0.030). Optimal depth correlated with patient height (adjusted coefficient=0.888, P<0.001).
In paediatric patients younger than 24 months, use of the ultrasound-guided lung sliding sign was more accurate than auscultation for optimal positioning of the tracheal tube.
KCT 0003015.
在小儿气管插管后，气管导管尖端应位于气管中段。听诊不能保证气管导管的最佳位置。我们比较了听诊和超声引导下的肺滑动征来确认小儿气管导管的最佳位置。
我们研究了 74 名年龄在 0-24 个月、ASA 身体状况 1-3 级、拟在全身麻醉下接受择期手术的小儿患者。所有患者均随机分为两组：听诊确认气管导管深度（A 组）或使用超声引导下的肺滑动征（S 组）。
S 组 37 例中有 32 例（87%）、A 组 37 例中有 24 例（65%）观察到气管导管的最佳位置（比例差异，22%；95%置信区间，2-39%；P=0.030）。最佳深度与患者身高相关（调整系数=0.888，P<0.001）。
在 24 个月以下的小儿患者中，与听诊相比，超声引导下的肺滑动征更能准确确定气管导管的最佳位置。
KCT 0003015。
