Singh Shubhi, Jindal Parul, Ramakrishnan Priya, Raghuvanshi Shailendra
Department of Anaesthesiology, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India.
Department of Radiodiagnosis, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India.
Saudi J Anaesth. 2019 Apr-Jun;13(2):93-99. doi: 10.4103/sja.SJA_390_18.
Paediatric airway assessment remains the most challenging task before the anaesthesiologists. Recent advancement in ultrasonography techniques should now allow for accurate and descriptive evaluation of paediatric airway. To compare calculated external diameters of the endotracheal tube from physical indices of traditional formulas and predetermined by ultrasound.
100 subjects of either sex between 12-60 months of age, undergoing various elective surgeries under general anaesthesia requiring endotracheal intubation were enrolled in the study. The transverse diameter was measured at the level of cricoids cartilage by ultrasonography. The tracheal tube was considered best fit if air leak was satisfactory at 15-20 cm HO of airway pressure. The obtained values were compared with the values of endotracheal tube size calculated by various age, height, weight based formulas and diameter of right and left little finger. The correlation of size of Endotracheal tube by different modalities was done and Pearson's correlation coefficient was obtained.
According to Pearson's correlation there was a moderate correlation of best fit Endotracheal tube with endotracheal tube size by age based formula ( = 0.743), body length based formula ( = 0.683), right little finger based formula ( = 0.587), left little finger based formula ( = 0.587) and multivariate formula ( = 0.741). There was a strong correlation with ultrasonography ( = 0.943).
Ultrasonography is a reliable method of estimation of subglottic diameter and for prediction of endotracheal tube size in children.
小儿气道评估仍然是麻醉医生面临的最具挑战性的任务。超声技术的最新进展现在应该能够对小儿气道进行准确且具描述性的评估。比较通过传统公式的身体指标计算得出的气管导管外径与超声预先确定的外径。
选取100名年龄在12至60个月之间、接受全身麻醉下各种择期手术且需要气管插管的受试者纳入研究。通过超声在环状软骨水平测量横径。如果气道压力在15 - 20 cmH₂O时漏气情况令人满意，则认为气管导管最合适。将获得的值与通过各种基于年龄、身高、体重的公式以及左右小指直径计算出的气管导管尺寸值进行比较。对不同方式得出的气管导管尺寸的相关性进行分析，并获得皮尔逊相关系数。
根据皮尔逊相关性分析，最合适的气管导管与基于年龄的公式计算出的气管导管尺寸（r = 0.743）、基于身长的公式（r = 0.683）、基于右手小指的公式（r = 0.587）、基于左手小指的公式（r = 0.587）以及多变量公式（r = 0.741）之间存在中度相关性。与超声检查存在强相关性（r = 0.943）。
超声检查是估计小儿声门下直径和预测气管导管尺寸的可靠方法。
