Significance of the outer diameter of an endotracheal tube: a lesser-known parameter

Gupta, Bhavna; Gupta, Lalit

doi:10.4097/kja.d.18.00056

Cited by 13 publications

(8 citation statements)

References 3 publications

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“…A previous study including Caucasians demonstrated adult subglottic diameters of 21.0 mm and 19.0 mm in males and females, respectively [20]. These diameters were larger than the ODs of the recommended ETTs [27]. By contrast, the OD of an ETT with a size of 7.5 is barely 1 mm smaller than the average subglottic diameter among normal Chinese females in this study.…”

Section: Discussioncontrasting

confidence: 67%

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

et al. 2020

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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,

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Section: Discussioncontrasting

confidence: 67%

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

et al. 2020

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“…This warrants selecting the smallest possible endotracheal tube to provide adequate lung isolation and airway pressure. It is imperative to understand that the outer diameter, not the inner diameter, is implicated in vocal cord trauma, postoperative hoarseness, and airway edema (31). Therefore, it is crucial to ascertain both internal and external diameters to allow smooth passage of the ETT and DLT through the fixed, narrowed glottic aperture with the vocal cord implant.…”

Section: Choice Of Endotracheal Tubesmentioning

confidence: 99%

Challenge of Lung Isolation in Patients with Vocal Cord Implants

et al. 2022

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: Glottic closure insufficiency increases the risk of aspiration and pneumonia, particularly in the elderly. Medialization thyroplasty is an open surgical procedure for treating glottic incompetency by approximating both vocal folds. The vocal fold medialization is achieved by inserting an implant to bring the nonmobile fold to the unaffected side. Lung isolation in patients with vocal cord implantation poses a unique challenge. Understanding the risks of different modalities of lung isolation and their impacts on the vocal cord implant is crucial to implementing a specifically tailored plan. Preoperative bronchoscopy, intraoperative video laryngoscopy, and bronchoscopy are ideal methods for assessing the vocal fold implants and guiding the lung isolation technique. Bronchial blocker through a single-lumen endotracheal tube may be the preferred choice to avoid the injury of the stretched vocal cords and dislodgement of the implant by a larger diameter double-lumen tube.

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“…9 Others have subsequently followed in the pursuit of more accurate transverse diameter measurements and conversions with varying success. [10][11][12][13][14] This ultrasound technique is also not suitable for ETT sizing in adults due to laryngeal calcification.…”

Section: Endotracheal Size Estimationmentioning

confidence: 99%

Neonatal and paediatric point‐of‐care ultrasound review

Pan

Lin

Tsui

2022

Australas J Ultrason Med

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Purpose Point‐of‐care ultrasound (POCUS) examinations for children and newborns are different from POCUS exams for adults due to dissimilarities in size and body composition, as well as distinct surgical procedures and pathologies in the paediatric patient. This review describes the major paediatric POCUS exams and how to perform them and summarizes the current evidence‐based perioperative applications of POCUS in paediatric and neonatal patients. Method Literature searches using PubMed and Google Scholar databases for the period from January 2000 to November 2021 that included MeSH headings of [ultrasonography] and [point of care systems] and keywords including “ultrasound” for studies involving children aged 0 to 18 years. Results Paediatric and neonatal POCUS exams can evaluate airway, gastric, pulmonary, cardiac, abdominal, vascular, and cerebral systems. Discussion POCUS is rapidly expanding in its utility and presence in the perioperative care of paediatric and neonatal patients as their anatomy and pathophysiology are uniquely suited for ultrasound imaging applications that extend beyond the standard adult POCUS exams. Conclusions Paediatric POCUS is a powerful adjunct that complements and augments clinical diagnostic evaluation and treatment.

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Significance of the outer diameter of an endotracheal tube: a lesser-known parameter

Cited by 13 publications

References 3 publications

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

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

Challenge of Lung Isolation in Patients with Vocal Cord Implants

Neonatal and paediatric point‐of‐care ultrasound review

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