The Feasibility of Ultrasound to Assess Subglottic Diameter

Lakhal, Karim; Delplace, Xavier; Cottier, Jean-Philippe; Tranquart, F.; Sauvagnac, Xavier; Mercier, C.; Fusciardi, J.; Laffon, M.

doi:10.1213/01.ane.0000260136.53694.fe

Cited by 161 publications

(115 citation statements)

References 16 publications

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“…11,12 However, the extent to which ultrasonography can predict optimal ETT size in pediatric patients remains to be determined. Therefore, we tested the hypothesis that subglottic diameter, as determined by ultrasonography, better predicts optimal ETT size than existing methods.…”

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confidence: 99%

“…A total of approximately 15 procedures are required for operators to obtain reliable and reproducible measurements. 11 Another concern about ultrasonic measurements is that age-dependent physiologic calcification of the larynx creates an acoustic shadow. However, as calcification begins to occur in the laryngeal cartilage during the third decade of life, ultrasonography can be applied with few problems in pediatrics.…”

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confidence: 99%

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Prediction of Pediatric Endotracheal Tube Size by Ultrasonography

Shibasaki¹,

Nakajima

Ishii³

et al. 2010

Anesthesiology

208

190

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Background: Formulas based on age and height often fail to reliably predict the proper endotracheal tube (ETT) size in pediatric patients. We, thus, tested the hypothesis that subglottic diameter, as determined by ultrasonography, better predicts optimal ETT size than existing methods. Methods: A total of 192 patients, aged 1 month to 6 yr, who were scheduled for surgery and undergoing general anesthesia were enrolled and divided into development and validation phases. In the development group, the optimal ETT size was selected according to standard agebased formulas for cuffed and uncuffed tubes. Tubes were replaced as necessary until a good clinical fit was obtained. Via ultrasonography, the subglottic upper airway diameter was determined before tracheal intubation. We constructed a regression equation between the subglottic upper airway diameter and the outer diameter of the ETT finally selected. In the validation group, ETT size was selected after ultrasonography using this regression equation. The primary outcome was the fraction of initial cuffed and uncuffed tube sizes, as selected through the regression formula, that proved clinically optimal. Results: Subglottic upper airway diameter was highly correlated with outer ETT diameter deemed optimal on clinical grounds. The rate of agreement between the predicted ETT size based on ultrasonic measurement and the final ETT size selected clinically was 98% for cuffed ETTs and 96% for uncuffed ETTs. Conclusions:Measuring subglottic airway diameter with ultrasonography facilitates the selection of appropriately sized ETTs in pediatric patients. This selection method better predicted optimal outer ETT diameter than standard age-and height-based formulas.

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confidence: 99%

mentioning

confidence: 99%

Prediction of Pediatric Endotracheal Tube Size by Ultrasonography

Shibasaki¹,

Nakajima

Ishii³

et al. 2010

Anesthesiology

208

190

View full text Add to dashboard Cite

show abstract

“…A few studies have also used the ultrasound to calculate the appropriate size of endotracheal and double lumen tubes. 26,27 Cricothyroidotomy Cricothyroidotomy can be a life-saving procedure in an unanticipated difficult airway in a to can't intubate and can't ventilate (CICV) scenario. It can also be used prophylactically prior to induction of anaesthesia in an anticipated difficult intubation.…”

Section: Ijutpcmentioning

confidence: 99%

Role of Ultrasound in Airway Assessment and Management

Kajekar¹,

Mendonca²,

Gaur³

2010

IJUTPC

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Ultrasound has gained widespread popularity in several aspects of perioperative and intensive care management. There is now growing evidence of it being a useful tool in the assessment and management of potentially difficult airway. With advances in technology and greater understanding of sonographic clinical anatomy, a greater insight into its uses has been gained. This article gives an overview of the possible clinical applications of ultrasound in day to day airway management in anaesthesia and intensive care.

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“…Only extrathoracic airway structures, such as the subglottic trachea, can be measured [102]. Endoscopic ultrasound, originally developed for gastrointestinal assessment in the 1980s, has been adapted to the bronchoscope and today, linear array endobronchial ultrasound (EBUS), is widely used for lung cancer diagnosis and staging.…”

Section: Endobronchial Ultrasoundmentioning

confidence: 99%

Quantifying tracheobronchial tree dimensions: methods, limitations and emerging techniques

Williamson¹,

James²,

Phillips³

et al. 2009

Eur Respir J

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The ability to measure airway dimensions is important for clinicians, interventional bronchoscopists and researchers in order to accurately quantify structural abnormalities and track their changes over time or in response to treatment.Most quantitative airway measurements are based on X-ray computed tomography and, more recently, on multidetector computed tomography. Quantitative bronchoscopic techniques have also been developed, although these are less widely employed. Emerging techniques, including magnetic resonance imaging, endoscopic optical coherence tomography, endobronchial ultrasound and confocal endomicroscopy, provide new research tools with potential clinical applications.An understanding of issues related to the acquisition, processing and analysis of images, and how such issues impact on imaging the tracheobronchial tree, is essential in order to assess measurement accuracy and to make effective use of the newer methods. This article contributes to this understanding by providing a comprehensive review of current and emerging techniques for quantifying airway dimensions.KEYWORDS: Airway dimensions, confocal endomicroscopy, multidetector computed tomography, optical coherence tomography, videobronchoscopy A dvances over the past 20 yrs in medical imaging and bronchoscopy have heralded an era of unprecedented access to quantitative information on tracheobronchial structure and, increasingly, function. The expanding scope of technical advances challenges the ability of clinicians and researchers to keep abreast of recent developments and emerging techniques. Computed tomography (CT) and, to a lesser extent, bronchoscopy are the two imaging tools that have contributed most to our understanding of the airway in vivo and are used on a daily basis by clinicians in the management of airway diseases. Newer techniques, such as magnetic resonance imaging, optical coherence tomography, fibreoptic confocal endomicroscopy and endobronchial ultrasound, offer fresh insights into the way we view and quantify the airway.Over the coming years, the clinical applications of these newer techniques will be defined. As with endobronchial ultrasound, which has been adopted by interventional bronchoscopists in a little over a decade from its first reported use [1], it is likely that smoking-related lung diseases, such as bronchogenic cancer and chronic obstructive pulmonary disease (COPD), will drive the rapid development of new endoscopic imaging modalities and maintain the current pace of technical improvements of existing techniques, in particular CT. Initial applications of these techniques may focus on screening and surveillance of endobronchial malignancies and the use of real-time airway measurements during interventional procedures to deploy endobronchial stents. In these settings, accurate real-time quantitative imaging is advantageous.

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The Feasibility of Ultrasound to Assess Subglottic Diameter

Abstract: In young healthy adults, ultrasonography appeared to be a reliable tool to assess the diameter of the subglottic upper airway.

Cited by 161 publications

References 16 publications

Prediction of Pediatric Endotracheal Tube Size by Ultrasonography

Prediction of Pediatric Endotracheal Tube Size by Ultrasonography

Role of Ultrasound in Airway Assessment and Management

Quantifying tracheobronchial tree dimensions: methods, limitations and emerging techniques

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