Appropriate placement of intubation depth marks in a new cuffed paediatric tracheal tube

Greenland, K., Chong, D. and Irwin, M. (2005) Appropriate placement of intubation depth marks in a new cuffed paediatric tracheal tube. BJA : British Journal of Anaesthesia, 94 1: 80-87. doi:10.1093/bja/aeh294


Author Greenland, K.
Chong, D.
Irwin, M.
Title Appropriate placement of intubation depth marks in a new cuffed paediatric tracheal tube
Journal name BJA : British Journal of Anaesthesia   Check publisher's open access policy
ISSN 0007-0912
1471-6771
Publication date 2005-01-01
Sub-type Article (original research)
DOI 10.1093/bja/aeh294
Open Access Status
Volume 94
Issue 1
Start page 80
End page 87
Total pages 8
Place of publication London
Publisher Oxford University Press
Language eng
Subject 110301 Anaesthesiology
Formatted abstract
Background.
The aim of this study was to evaluate the appropriateness of intubation depth marks on the new Microcuff paediatric tracheal tube.

Methods.
With local Institutional Ethics Committee approval and informed parental consent, we included patients from birth (weighing ≥3 kg) to 16 yr who were undergoing general anaesthesia requiring orotracheal intubation. Tracheal intubation was performed using direct laryngoscopy, the intubation depth mark was placed between the vocal cords, and the tube was taped to the lateral corner of the mouth. The distance between the tube tip and the tracheal carina was assessed by flexible bronchoscopy with the patients in supine, and their head in neutral positions. Tube sizes were selected according to the formula: internal diameter (ID; mm)=(age/4)+3.5 in children ≥2 yr. In full-term newborns (≥3 kg) to less than 1 yr ID 3.0 mm tubes were used and in children from 1 to less than 2 yr ID 3.5 mm tubes were used. Endoscopic examination was performed in 50 size ID 3.0 mm tubes, and in 25 tubes of each tube size from ID 3.5 to 7.0 mm. Tracheal length and percentage of the trachea to which the tube tip was advanced were calculated.

Results.
250 patients were studied (105 girls, 145 boys). The distance from the tube tip to the carina ranged from 1.4 cm in a 2-month-old infant (ID 3.0 mm) to 7.7 cm in a 14-yr-old boy (ID 7.0 mm). Mean tube insertion into the trachea was 53.2% (6.3) of tracheal length with a minimum of 40% and a maximum of 67.6%.

Conclusions.
The insertion depth marks of the new Microcuff paediatric tracheal tube allow adequate placing of the tracheal tube with a cuff-free subglottic zone and without the risk for endobronchial intubation in children from birth to adolescence.
Q-Index Code CX

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Fri, 17 Apr 2009, 21:43:12 EST by Ms Karen Naughton on behalf of Anaesthesiology and Critical Care - RBWH