Abstract
We aimed to evaluate the efficacy of using airway ultrasonography to select the correct tracheal tube size and insertion depth in pediatric patients who underwent cleft repair surgery as a way to decrease airway complications and adverse events during perioperative periods. Fifty-one patients (age < 28 months) were consecutively divided into conventional (n = 28) and ultrasound (n = 23) groups. Tracheal tube size and insertion depth were determined using the age-based formula and auscultation in the conventional group, whereas using ultrasonographic measurement of subglottic diameter with auscultation and lung ultrasonography in the ultrasound group. We evaluated the initially selected tube size, insertion depth, ventilatory indices, and the incidence of airway complications and adverse events. Tube insertion depth (median [interquartile range]) was significantly greater in the ultrasound group than in the conventional group (13.5 cm [12.5–14.0] vs 13.0 cm [11.8–13.0], P = 0.045). The number of complications and adverse events was significantly higher in the conventional group than in the ultrasound group (32.1% vs 4.3%, P = 0.013). Airway ultrasound application could reduce airway-related complications and adverse events by determining the appropriate tracheal tube size and insertion depth.
Highlights
We aimed to evaluate the efficacy of using airway ultrasonography to select the correct tracheal tube size and insertion depth in pediatric patients who underwent cleft repair surgery as a way to decrease airway complications and adverse events during perioperative periods
The principal finding of this study was that tracheal tube size and insertion depth selection using airway ultrasonography in pediatric patients undergoing cleft repair surgery helped to decrease perioperative airway complications and adverse events
We studied pediatric patients undergoing cleft repair surgery because they are vulnerable to airway morbidity, and the conventional age-based formula for tube selection is empirical and only used in patients aged 2 years and above[6,7,8]
Summary
We aimed to evaluate the efficacy of using airway ultrasonography to select the correct tracheal tube size and insertion depth in pediatric patients who underwent cleft repair surgery as a way to decrease airway complications and adverse events during perioperative periods. Tracheal tube size and insertion depth were determined using the age-based formula and auscultation in the conventional group, whereas using ultrasonographic measurement of subglottic diameter with auscultation and lung ultrasonography in the ultrasound group. Airway ultrasound application could reduce airwayrelated complications and adverse events by determining the appropriate tracheal tube size and insertion depth. The risk of airway complications and adverse events is higher due to airway obstruction, difficulty in intubation, and tracheal tube-related problems[2,3]. Tracheal and thoracic ultrasonography can be used for selecting the correct size of tube and verifying its tracheal p osition[12,13]
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