Back to Basics: Endotracheal Tube Too Deep, Too Shallow, Then Just Right

Ganti, Latha; Shivdat, John; Bawany, Sheila

doi:10.7759/cureus.2706

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…Over-intubation into the right mainstem bronchus increases the risks of hypoventilation, pneumothorax, and atelectasis. Conversely, under-insertion may incorrectly position the cuff over the vocal cords, causing trauma or accidental extubation [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Predicting dog tracheal diameter and length: A tool for improved intubation

in,

Kananub,

Sritrakul

et al. 2024

J Adv Vet Anim Res

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Objective: This study aims to develop formulas for estimating tracheal diameter and length in dogs using easily measurable anatomical parameters. Materials and Methods: The samples consisted of 20 dogs of various breeds, comprising 10 males and 10 females, sourced from cadavers. The measured parameters included occipital tuberosity to tail base (OT), eye angle to ear tragus, nose to ear tragus, inner vertical diameters (IVD), and tracheal length (TL). The study conducted correlation and linear regression analyses, and subsequently, the formulated models underwent validation using 16 live dogs. The results were compared to radiographic measurements. Results: Linear regression recommended formulas based on OT, resulting in IVD (mm) = 0.203 × OT – 3.724 (r2 = 0.608, p < 0.001) and TL (cm) = 0.346 × OT–3.773 (r2 = 0.837, p < 0.001). The predicted tracheal diameter and length from formulas were slightly smaller than radiographic measurements (IVD = 2.76 ± 1.85 mm, p < 0.0001 and TL = 2.07 ± 1.81 cm, p < 0.0001). Conclusion: These formulas offer a practical way to estimate tracheal dimensions in live dogs, facilitating the selection of suitable endotracheal tube sizes and insertion depth. Further studies with larger sample sizes and consistent measurement methods can enhance the accuracy of these findings.

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Section: Introductionmentioning

confidence: 99%

Predicting dog tracheal diameter and length: A tool for improved intubation

in,

Kananub,

Sritrakul

et al. 2024

J Adv Vet Anim Res

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“…Pediatric endotracheal intubation is mandatory in elective surgery and critically ill children 1 , 2 . However, endotracheal tube (ET) misplacement is common in pediatric patients with short tracheal lengths compared to adults; thus, it is challenging to determine the appropriate depth of ET 3 – 5 .…”

Section: Introductionmentioning

confidence: 99%

Predicting the risk of inappropriate depth of endotracheal intubation in pediatric patients using machine learning approaches

Shim

Lee

et al. 2023

Sci Rep

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Endotracheal tube (ET) misplacement is common in pediatric patients, which can lead to the serious complication. It would be helpful if there is an easy-to-use tool to predict the optimal ET depth considering in each patient’s characteristics. Therefore, we plan to develop a novel machine learning (ML) model to predict the appropriate ET depth in pediatric patients. This study retrospectively collected data from 1436 pediatric patients aged < 7 years who underwent chest x-ray examination in an intubated state. Patient data including age, sex, height weight, the internal diameter (ID) of the ET, and ET depth were collected from electronic medical records and chest x-ray. Among these, 1436 data were divided into training (70%, n = 1007) and testing (30%, n = 429) datasets. The training dataset was used to build the appropriate ET depth estimation model, while the test dataset was used to compare the model performance with the formula-based methods such as age-based method, height-based method and tube-ID method. The rate of inappropriate ET location was significantly lower in our ML model (17.9%) compared to formula-based methods (35.7%, 62.2%, and 46.6%). The relative risk [95% confidence interval, CI] of an inappropriate ET location compared to ML model in the age-based, height-based, and tube ID-based method were 1.99 [1.56–2.52], 3.47 [2.80–4.30], and 2.60 [2.07–3.26], respectively. In addition, compared to ML model, the relative risk of shallow intubation tended to be higher in the age-based method, whereas the risk of the deep or endobronchial intubation tended to be higher in the height-based and the tube ID-based method. The use of our ML model was able to predict optimal ET depth for pediatric patients only with basic patient information and reduce the risk of inappropriate ET placement. It will be helpful to clinicians unfamiliar with pediatric tracheal intubation to determine the appropriate ET depth.

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Back to Basics: Endotracheal Tube Too Deep, Too Shallow, Then Just Right

Cited by 2 publications

References 9 publications

Predicting dog tracheal diameter and length: A tool for improved intubation

Predicting dog tracheal diameter and length: A tool for improved intubation

Predicting the risk of inappropriate depth of endotracheal intubation in pediatric patients using machine learning approaches

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