Correlation Between Anthropometric Characteristics and Age-based Formulas for Uncuffed Pediatric Endotracheal Tube

Mother and Child Health Institute of Serbia Dr Vukan Cupic

Status: Completed

Conditions: Endotracheal Tube; Finger

Study type: Observational

Funder types: Other

Identifiers

NCT07349953

8/148

Details and patient eligibility

About

The goal of this observational study is to investigate the correlation between anthropometric characteristics, such as finger circumferences, body weight, body height, and body mass index, and age-based formulas for uncuffed tube size in pediatric patients up to 8 years of age.

Full description

Patients who met inclusion criteria entered the study. All included patients were premedicated with midazolam 0.1mg/kg IV 30 minutes before general anesthesia. Induction: propofol 2,5mg/kg IV, rocuronium 0,6mg/kg IV, fentanyl 3mcg/kg IV; maintenance: sevoflurane 1vol% - 2vol%, fentanyl 3mcg/kg IV as needed. reversion of neuromuscular block was achieved using sugammadex. Trachea was intubated using direct laryngoscopy. Intubation performed one anesthesiologist with more than 10 years of clinical experience in pediatric anesthesia. Initial choice of endotracheal tube (ET) was based on the size of little finger. Proper position of ET was confirmed with chest auscultation, capnography and capnometry. If placing ET was difficult or air leak was not detected using inspiratory pressure > 25cmH2O,ET was replaced with 0,5mm smaller one. If there was air leak using inspiratory pressure < 10 mmHg ET was replaced with 0.5mm bigger one. All children were ventilated using protective strategy. After intubation, measures were made:

1. Finger's circumference was measured with flexible ruler tape (in millimeters). The tape was wrapped around the base of the finger. Circumferences of index finger, middle finger, ring finger and small finger were documented for each hand.
2. Data of body weight, body height and body mass index were taken from patients history.
3. Sizes of used endotracheal tubes were documented.
4. Calculations of ET tube size using age based formulas were made:

for children over 2 years ID (mm) = god/4+4 for children under 2 years of age ODcal (mm) = 0,00223x age(days)+4.88

Enrollment: 103 patients

Sex: All

Ages: 1 day to 8 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age up to 8 years of age;
• Children without congenital and acquired anomalies of the trachea;
• Children in whom tracheal intubation is planned as part of the anesthesia plan

Exclusion criteria

• Age over 8 years of age;
• The presence of congenital and acquired anomalies of the trachea;
• Children who are already intubated; and failure to obtain informed consent

Trial design

103 participants in 1 patient group

Peditric patients up to 8 years of age requiuring general anesthesia with endotracheal intubation

Description:

All patients were scheduled for surgery and elective intubation. Patient's body weight, height, body mass index, and finger circumference were documented. The tube size was selected based on an appropriate formula. After intubation, the circumference of the index, middle, ring, and little fingers of the right and left hands, as well as the child's body mass and height, were measured. The measurement was performed using a flexible meter at the joint of the palm and the root of the finger. Only one anesthesiologist performed the intubation. If the placement of the tube was difficult or there was no audible air leakage around the tube at an inspiratory pressure \> 20cmH2O, the selected tube was replaced with a smaller tube by 0.5 mm. If an audible air leak was documented after intubation at an inspiratory pressure of \< 10 mmHg, the tube was replaced with a larger tube by 0.5 mm.