Measurement of subglottic diameter and distance to pre-epiglottic space among Chinese adults

Abstract

Proper endotracheal tube (ETT) size selection and identification of potentially difficult airways are important to reduce laryngeal injury during intubation. However, controversies exist concerning transverse subglottic diameter-the narrowest part of the airway-and the distance to pre-epiglottic space. Because few studies have reported the distance from skin to the midpoint of the epiglottis (DSE) among normal individuals, whether the DSE varies between individuals and by ethnicity remains uncertain. The present study aims to investigate the sonographic subglottic diameter and DSE among healthy Chinese adults. Healthy volunteers were recruited at National Taiwan University Hospital between October and November 2019. Exclusion criteria included pre-existing airway or respiratory diseases, neck tumors, and a history of neck operation. Age, sex, height, weight, body mass index (BMI), sonographic DSE, and transverse subglottic diameter were recorded. A total of 124 participants were enrolled. The average age was 32.5 ± 10.4 years and 63 participants (51%) were males. The subglottic diameter was positively associated with sex (males, 14.40 mm; females, 11.10 mm,

Effect of varying cuff sizes with identical inner diameter on endotracheal intubation in critically ill adults: A sealed tracheal controlled trial

“…Thus, physicians utilize various methods when selecting ETTs for patients. [14,[16][17][18]24] However, the selection of the cuff is often overlooked. Thus, a set of comprehensive guidelines is necessary to determine the appropriate ETT cuff diameter for individuals from different nations.…”

“…[9][10][11] Several factors may contribute to this phenomenon. First, medical professionals tend to focus in selecting the correct inner diameter (ID) F size [12][13][14][15] using reliable tools, such as ultrasound and computed tomography (CT), in order to predict the appropriate ETT size for patients, [16,17] while overlooking the importance of choosing the correct cuff diameter. Second, even with the same ID size, the cuff diameter would vary among different ETT brands (Fig.…”

Risk factor evaluation of cuff pressure of >30 cmH2O to stop air leakage during mechanical ventilation: A prospective observational study

“…Several previous literatures have measured the trachea diameter in CT images, and suggested that the transverse diameter of the subglottic area and diameter of the cricoid cartilage can be measured to facilitate the selection of the appropriate size of endotracheal tube (Jugpal et al, 2015;Stagnaro et al, 2017;Wu et al, 2021). Other previous studies have revealed that the trachea size can vary, depending on the gender, age, height, and body mass index (Cao et al, 2021;Chan et al, 2020;Ritchie-McLean et al, 2018). In the present study, the tracheal area at the T3 level was measured, as shown in the CT images.…”

Pressure changes in tapered and cylindrical shaped cuff after extension of head and neck: A randomized controlled trial

“…The tips of the C-shaped cartilages are closer to each other in the proximal region than in the distal region of the trachea and the tracheal compliance is higher in the proximal region than in the distal region[ 20 , 21 ]. In addition, the subglottic space at level of cricoid cartilage is the narrowest[ 22 ]. Boyle’s law is a gas law which states the pressure of a gas is inversely proportional to its volume at constant temperature within a closed system.…”