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Comparison of four formulas for nasotracheal tube length estimation in pediatric patients: an observational study

Ashkan Taghizadeh Imani1, Mehrdad Goudarzi1, Niloufar Shababi1

  • 1Tehran University of Medical Sciences, Children...s Medical Center, Anaesthesiology Department, Tehran, Iran.

Brazilian Journal of Anesthesiology (Elsevier)
|May 1, 2021
PubMed

Insights

Accurate nasotracheal intubation is crucial for pediatric patients. A new formula, 0.1*Height+7, and L=3*tube size+2, effectively estimate tube length in children under 4, improving patient safety.

Area of Science:

  • Pediatric Anesthesiology
  • Medical Device Engineering
  • Clinical Research

Background:

  • Correct endotracheal intubation ensures adequate ventilation, prevents hypoxia, and minimizes re-intubation attempts.
  • Accurate nasotracheal intubation is vital for pediatric patients undergoing surgery.
  • Existing formulas for estimating nasotracheal tube length require further validation.

Purpose of the Study:

  • To compare the accuracy of different formulas for estimating nasotracheal tube length in children.
  • To identify the most reliable formula for determining optimal tube insertion distance.
  • To develop a new, accurate formula based on patient demographics.

Main Methods:

  • A cross-sectional retrospective study involving 102 pediatric patients (51 female, 51 male) undergoing cardiac surgery.
  • Nasotracheal intubation was confirmed by postintubation chest X-ray (CXR).
  • Four existing formulas were evaluated, and a new formula was derived using linear regression based on height, weight, and age.

Main Results:

  • The formula L=3*tube size+2 showed the strongest correlation with actual tube length (r=0.81).
  • Patient height demonstrated the highest correlation with tube length (r=0.83).
  • A new formula, nasotracheal tube length = 0.1*Height+7, was developed using linear regression.

Conclusions:

  • The formulas L=3*tube size+2 and the newly derived formula (0.1*Height+7) can reliably estimate nasotracheal tube length in children under 4.
  • These formulas serve as valuable guides but require clinical confirmation via auscultation and CXR.
  • Accurate tube length estimation enhances patient safety during pediatric anesthesia.
Abstract

Keywords:
AnesthesiaChildInfantIntratrachealIntubationPediatric

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