Anesthesiology Department, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, No. 289 of Kuocang Road, Liandu District, Lishui, Zhejiang, 323000, People's Republic of China.
Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6533-6538. doi: 10.1007/s00405-024-08923-3. Epub 2024 Sep 4.
We explored the use of ultrasonography in determining the minimal transverse diameter of the subglottic airway (MTDSA) for the purpose of choosing an appropriate model of reinforced cuffed endotracheal tube.
A total of 110 pediatric patients who received general anesthesia and tracheal intubation for selective surgeries at the hospital from February 2019 to February 2022 were chosen. They were then randomly assigned to three groups: 39 in the MTDSA group, 35 in the age formula group, and 36 in the height formula group. We assessed how accurately the appropriate endotracheal tube model was predicted in each group and compared their predictive performance.
The age range of the enrolled pediatric patients was 3-6 years old. The ultrasonic measurement method demonstrated a prediction accuracy of 87.18%, while the age formula method and height formula method exhibited lower accuracy rates of 54.29% and 47.22%, respectively. Notably, the ultrasonic measurement method outperformed the other two methods significantly (P < 0.05). In the MTDSA group, 2 patients had their catheters changed during anesthesia, and the proportion of patients who changed their catheters was 5.13%. In the MTDSA group, 6 catheters were replaced, and the frequency of catheter replacement was 15.38%. In contrast, these percentages were much higher in the age formula group, at 31.43% and 45.71%, and in the height formula group, at 36.11% and 52.78%. The latter two groups had significantly higher values than the MTDSA group (P < 0.05). Regarding complications such as hoarseness, laryngeal edema, aspiration, and laryngospasm, the MTDSA group experienced a notably lower total incidence of 7.69% compared to the 37.14% in the age formula group and 41.67% in the height formula group, demonstrating statistical significance (P < 0.05).
The ultrasonic measurement technique employed in MTDSA exhibits impressive precision when it comes to forecasting the specific model of a reinforced cuffed endotracheal tube for pediatric patients. This enhanced accuracy contributes significantly to minimizing the need for tube replacements during anesthesia and the associated complications. It holds immense importance in assisting clinicians in selecting the most appropriate pediatric endotracheal tube model for anesthesia induction.
探讨超声测量声门下气道最小横径（MTDSA）在选择强化套囊气管导管模型中的应用。
选择 2019 年 2 月至 2022 年 2 月在我院行择期手术全身麻醉并气管插管的患儿 110 例，随机分为 MTDSA 组 39 例、年龄公式组 35 例、身高公式组 36 例。评估各组预测合适气管导管模型的准确性，并比较其预测性能。
纳入患儿年龄 3～6 岁。超声测量法预测准确率为 87.18%，年龄公式法和身高公式法准确率分别为 54.29%和 47.22%，超声测量法明显优于其他两种方法（P<0.05）。在 MTDSA 组，2 例患者在麻醉期间更换了导管，更换导管的患者比例为 5.13%。MTDSA 组更换 6 根导管，更换频率为 15.38%。相比之下，年龄公式组和身高公式组的更换率明显更高，分别为 31.43%和 45.71%，52.78%。后两组与 MTDSA 组比较差异有统计学意义（P<0.05）。在声嘶、喉水肿、吸入性肺炎和喉痉挛等并发症方面，MTDSA 组总发生率为 7.69%，明显低于年龄公式组的 37.14%和身高公式组的 41.67%，差异有统计学意义（P<0.05）。
MTDSA 中使用的超声测量技术在预测小儿强化套囊气管导管的具体型号方面具有令人印象深刻的精度。这种精度的提高显著降低了麻醉期间更换导管的需求和相关并发症的发生。它对于帮助临床医生选择最合适的小儿气管导管模型用于麻醉诱导具有重要意义。
