Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Paediatr Anaesth. 2021 Dec;31(12):1304-1309. doi: 10.1111/pan.14301. Epub 2021 Sep 30.
Accurate insertion depth of endotracheal tube (ETT) in children has been predicted using the demographic variables, such as age, weight, and height. Middle finger length showed good correlation with ETT depth measurement in children aged 4-14 years.
The primary objective was to correlate the actual ETT insertion depth with the depth derived from middle finger length, age, weight, and height formulae in children aged 1-4 years. The secondary objective was to find the most accurate formula for prediction of ETT insertion depth.
This prospective parallel group study was done in 50 american society of anesthesiologists 1 or 2 children aged 1-4 years undergoing elective surgery under general anesthesia. Children with difficult airway, finger anomalies, or syndromic associations were excluded. Age, weight, height, and middle finger length of all children were measured. Depth of orally inserted uncuffed ETT and tracheal length was measured by fiberoptic bronchoscopy. The actual ETT depth was correlated with the depth calculated from different formulae.
The mean middle finger length was 4.42 ± 0.50 cm, age was 2.64 ± 1.07 years, weight was 12.28 ± 2.84 kg, and height was 82.89 ± 16.23 cm. The mean tracheal length was 6.42 ± 0.96 cm. The mean depth of ETT was actual depth (12.89 ± 1.09 cm), middle finger depth (13.23 ± 1.53cm; p = .001; 95%CI 0.12-0.50), age-based depth 1(3.31 ± 0.53 cm; 95%CI 0.37-1.44; p = .001), weight-based depth (14.14 ± 1.42 cm; 95% CI 0.10-0.51; p = .004), and height-based depth (13.73 ± 0.94 cm; 95% CI 0.15-0.77; p = .004). Middle finger length and age-based formulae showed higher number of accurate placements (58% each). Weight- (74%) and height (64%)-derived formulae gave a higher number of distal ETT placements.
Formulas based on the demographic variables and middle finger length showed good correlation with the actual ETT depth in children aged 1-4 years. The percentage of accurate ETT depth placements was higher with middle finger length and age-based formulae.
已有研究通过年龄、体重和身高等人口统计学变量预测儿童气管内导管（ETT）的准确插入深度。在 4-14 岁的儿童中，中指长度与 ETT 深度测量具有良好的相关性。
本研究旨在探讨 1-4 岁儿童的实际 ETT 插入深度与通过中指长度、年龄、体重和身高公式计算得出的 ETT 深度之间的关系，并寻找预测 ETT 插入深度最准确的公式。
本前瞻性平行组研究纳入了 50 名美国麻醉医师协会（ASA）分级为 1 级或 2 级、接受全身麻醉下择期手术的 1-4 岁儿童。排除存在气道困难、手指畸形或综合征的患儿。测量所有患儿的年龄、体重、身高和中指长度。通过纤维支气管镜测量经口插入的无套囊 ETT 的实际深度和气管长度。实际 ETT 深度与不同公式计算得出的深度进行相关性分析。
患儿的平均中指长度为 4.42±0.50cm，年龄为 2.64±1.07 岁，体重为 12.28±2.84kg，身高为 82.89±16.23cm。平均气管长度为 6.42±0.96cm。ETT 的实际深度为 12.89±1.09cm，中指深度为 13.23±1.53cm（p=0.001；95%CI 0.12-0.50），年龄相关公式深度为 3.31±0.53cm（95%CI 0.37-1.44；p=0.001），体重相关公式深度为 14.14±1.42cm（95%CI 0.10-0.51；p=0.004），身高相关公式深度为 13.73±0.94cm（95%CI 0.15-0.77；p=0.004）。中指长度和年龄公式预测的 ETT 位置准确率较高（各为 58%）。体重（74%）和身高（64%）公式预测的 ETT 位置更偏向远端。
基于人口统计学变量和中指长度的公式与 1-4 岁儿童的实际 ETT 深度相关性良好。通过中指长度和年龄公式预测 ETT 深度的准确率较高。
