Role of ultrasound measuring position and ventilation pressure in determining correct tube size in children

Schramm, Christoph; Eisleben, Luzie S.; Keßler, Jens; Jensen, Katrin; Plaschke, Konstanze

doi:10.1111/pan.13267

Cited by 8 publications

(9 citation statements)

References 16 publications

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“…A total of 3638 articles were searched, and 33 articles met our inclusion criteria [ 4 , 5 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Figure 1 shows a flow chart of the literature search.…”

Section: Resultsmentioning

confidence: 99%

“…Figure 1 shows a flow chart of the literature search. Six studies were randomized controlled trials (RCTs) [ 4 , 11 , 12 , 20 , 25 , 27 ] and the others were diagnostic studies [ 5 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 21 , 22 , 23 , 24 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], the characteristics of which are summarized in Supplementary Table S2 . The risk of bias and applicability concerns are presented in Figure 2 and Supplementary Figure S1 .…”

Section: Resultsmentioning

confidence: 99%

“…We included 6 RCTs [ 4 , 11 , 12 , 20 , 25 , 27 ] and 16 diagnostic studies [ 5 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 21 , 22 , 23 , 24 , 26 , 28 , 29 , 30 ] that fulfilled our inclusion criteria, involving a total of 1816 patients who underwent airway ultrasound examinations 1503 times. All the studies were conducted in children undergoing elective surgery.…”

Section: Resultsmentioning

confidence: 99%

“…All the studies were conducted in children undergoing elective surgery. Except for four studies that included neonates and infants [ 14 , 30 ], most of the patients in the remaining studies were over 1 year old. The ultrasound inspection method involved placing the linear probe on the anterior midline of the neck and measuring the minimal transverse diameter of the subglottic airway (MTDSA) at the level of the cricoid cartilage.…”

Section: Resultsmentioning

confidence: 99%

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Applications of Airway Ultrasound for Endotracheal Intubation in Pediatric Patients: A Systematic Review

Liu

2023

JCM

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Endotracheal intubation is a challenging procedure for pediatric patients. Airway ultrasound as a new technology is suitable for aiding this process, but its diagnostic value remains unclear. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and the Chinese biomedical literature database to summarize specific applications of airway ultrasound in each step of endotracheal intubation in pediatric patients. Diagnostic accuracy and 95% confidence interval were used as outcomes. In total, 33 studies (6 randomized controlled trials and 27 diagnostic studies) with 1934 airway ultrasound examinations were included. Population included neonates, infants, and older children. Airway ultrasound could be used to determine the endotracheal tube size and confirm endotracheal intubation and intubation depth; the diagnostic accuracy for all these factors was 23.3–100%, 90.6–100%, and 66.7–100%, respectively. Furthermore, the accuracy of airway ultrasound in predicting endotracheal tube size was consistently higher than traditional methods, such as height formula, age formula, and the width of the little finger. In conclusion, airway ultrasound has unique advantages for confirming successful endotracheal intubation in pediatric patients, and it may become an effective auxiliary tool in this field. There is a need to develop a unified airway ultrasound protocol to conduct clinical trials and practice in the future.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Applications of Airway Ultrasound for Endotracheal Intubation in Pediatric Patients: A Systematic Review

Liu

2023

JCM

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“…Therefore, discordant ETT size and difficult intubation should be separate concerns and implemented in respective strategies. Currently some advanced techniques such as ultrasound [ 24 , 25 ] and printed three-dimensional airway model [ 26 ] have been applied for measuring the diameter of pediatric trachea and predicting ETT size. Further investigation of these new techniques applied to MPS patients is necessary.…”

Section: Discussionmentioning

confidence: 99%

The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study

Lao

Lin

Liang

et al. 2022

JPM

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Anesthesia for patients with mucopolysaccharidoses (MPS) is quite challenging due to vital systemic dysfunction following progressive accumulation of lysosomal glycosaminoglycans. Previous studies focused on perioperative difficult airway management under general anesthesia but rarely depicted the concern of choosing the size of the endotracheal tube (ETT) as well as neuraxial anesthesia. This study aimed to analyze the overall anesthetic management and related complications for a thorough anesthetic strategy. Within the study period from 2002 to 2021, each record of the anesthetic and perioperative quality assurance/improvement system for patients with a diagnosis of MPS at MacKay Memorial Hospital was retrospectively reviewed. A total of 51 individuals with 151 anesthesia for 163 interventions were cohort studied, and there were 136 general anesthesia and 15 neuraxial anesthesia. We found that the most common interventions for MPS patients were otolaryngological surgeries (49.6%). Additionally, a secured airway played a marked preference for the most general anesthesia (87.1%). The incidence of difficult intubation was 12.5%. In view of ETT size, a smaller than estimated size was used in MPS type Ⅱ, Ⅲ, Ⅳ, and Ⅵ patients and \also in patients who received intubation with multiple attempts. However, a larger than estimated size of ETT was adopted whilst choosing cuffed ones. For neuraxial anesthesia, two failed spinal anesthesia procedures were converted to general anesthesia and 73 percent of the patients received perioperative sedation. In conclusion, through the individualized anesthetic strategy and build-up of an experienced team for airway management, high-quality anesthesia can be ensured in each patient.

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Pediatric point of care airway ultrasound (POCUS)

Guimarães Ferreira Fonseca,

Bertolizio,

Engelhardt

et al. 2024

Anaesthesiologie

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Role of ultrasound measuring position and ventilation pressure in determining correct tube size in children

Abstract: The airway level selected for ultrasound and airway pressure during measurement determines the rate of agreement between the measurement result and correct ETT size.

Cited by 8 publications

References 16 publications

Applications of Airway Ultrasound for Endotracheal Intubation in Pediatric Patients: A Systematic Review

Applications of Airway Ultrasound for Endotracheal Intubation in Pediatric Patients: A Systematic Review

The Anesthetic Strategy for Patients with Mucopolysaccharidoses: A Retrospective Cohort Study

Pediatric point of care airway ultrasound (POCUS)

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