Davis D, Barbee L, Ririe D
Gaston Anesthesia Associates, Gastonia, North Carolina, USA.
AANA J. 1998 Jun;66(3):299-303.
Many methods are taught and used clinically to determine what size uncuffed endotracheal tube is required for the pediatric patient. The purpose of this study was to compare the effectiveness of two methods of selection used clinically: (1) the traditional age-based (AB) formula; (age in years +16) divided by 4, and (2) the method based on body length using the Broselow pediatric resuscitation tape. Following institutional review board approval, 174 patients were prospectively studied after informed consent was obtained. Uncuffed endotracheal tube size selection was determined by randomly assigning the patient to one of the two groups. The appropriateness of the tube selection was assessed using an audible air leak around the endotracheal tube. No difference was found between the AB group and the resuscitation tape group with respect to selecting the appropriate size of endotracheal tube. Retrospective analysis of all patients found another AB formula that is occasionally used ([age in years +18] divided by 4) to be correct in only 20 (11%) of 174 cases. This was significantly different from the other methods (P < .001). Since the AB formula ([age in years +16] divided by 4) is reliable and easily applied, it appears acceptable for routine anesthesia cases in the pediatric population requiring endotracheal intubation. The AB formula ([age in years +18] divided by 4) should be used cautiously because of the high failure rate. In circumstances in which general information, such as age, is not available and endotracheal intubation is needed, the Broselow tape allows reliable endotracheal tube size identification and should be readily available.
临床上讲授并使用了多种方法来确定儿科患者所需的无套囊气管内导管尺寸。本研究的目的是比较临床上使用的两种选择方法的有效性：（1）传统的基于年龄（AB）的公式；（年龄（岁）+16）除以4，以及（2）使用 Broselow 儿科复苏带基于身长的方法。经机构审查委员会批准，在获得知情同意后对174例患者进行了前瞻性研究。通过将患者随机分配到两组之一来确定无套囊气管内导管尺寸的选择。使用气管内导管周围可闻及的漏气来评估导管选择的合适性。在选择合适尺寸的气管内导管方面，AB组和复苏带组之间未发现差异。对所有患者的回顾性分析发现，另一种偶尔使用的AB公式（[年龄（岁）+18]除以4）在174例病例中仅20例（11%）是正确的。这与其他方法有显著差异（P<0.001）。由于AB公式（[年龄（岁）+16]除以4）可靠且易于应用，对于需要气管插管的儿科人群的常规麻醉病例似乎是可以接受的。由于失败率高，AB公式（[年龄（岁）+18]除以4）应谨慎使用。在无法获得年龄等一般信息且需要气管插管的情况下，Broselow带可实现可靠的气管内导管尺寸识别，应随时可用。
