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[Finding appropriate tube position by the cuff palpation method in children]
M Okuyama1, M Imai, K Sugawara
1Department of Anesthesiology, Hokkaido University School of Medicine, Sapporo.
Insights
Palpating the endotracheal tube cuff between the cricoid cartilage and suprasternal notch is a reliable method for confirming correct endotracheal tube placement in children, preventing bronchial intubation.
Area of Science:
- Pediatric Anesthesiology
- Airway Management
Background:
- Accurate endotracheal tube placement is critical in pediatric anesthesia.
- Ensuring correct positioning prevents complications like bronchial intubation.
Purpose of the Study:
- To evaluate the efficacy of endotracheal tube cuff palpation for confirming proper placement in children.
- To establish a simple and reliable method for pediatric intubation verification.
Main Methods:
- A cuffed endotracheal tube was used in 59 children aged [age range not specified].
- Tube position was assessed by palpating the cuff between the cricoid cartilage and suprasternal notch.
- Fiberscopic measurement determined the distance from the carina to the tube tip.
Main Results:
- Palpation of the cuff correlated with a safe tube tip distance (>1.0 cm from the carina).
- No complications were reported with the use of cuffed endotracheal tubes in this cohort.
- The method proved rapid and simple for assessing tube position.
Conclusions:
- Cuff palpation is a safe, reliable, and simple technique for verifying endotracheal tube placement in pediatric patients.
- This method aids in preventing mainstem bronchial intubation during pediatric procedures.
Abstract:
The present study was designed to examine whether palpation of the endotracheal tube cuff indicates appropriate positioning in the children. In 59 children, we used a cuffed endotracheal tube (3.5-5 mm ID) to measure the distance from the carina to the distal tip of the endotracheal tube, when we can palpate the endotracheal tube cuff between the cricoid cartilage and the suprasternal notch. Following slow induction of anesthesia and muscle relaxation, each patient was intubated with a cuffed endotracheal tube of size suitable for age. The cuff was inflated with 0.5-1 ml of air, and palpated between the cricoid cartilage and the suprasternal notch. The distance between the carina and the tube tip measured by a fiberscope was more than 1.0 cm, which is thought to be safe to prevent bronchial intubation. The cuff was deflated after measurement. There were no complications attributable to use of cuffed endotracheal tubes. We concluded that the cuff palpation method was a rapid, reliable and simple technique to ensure the proper tube position in children.