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Journal of The Korean Society of Emergency Medicine 2016;27(5): 450-457. |
| 한국 소아에서 컴퓨터 단층 촬영 영상을 이용한 성문 하 가로지름 측정값과
커프가 있는 기관내관의 크기 결정을 위한 공식들의 비교 |
| 이건호1, 서영주2, 백진휘1, 정현민1, 김아진1, 김지혜1 |
1인하대학교 의과대학 응급의학교실
2인하대학교 의과대학 의생명과학교실 |
| The Measurement of Korean Pediatric Subglottic Transverse Diameter Using Computed Tomography Imaging and Validation of the Formulas for the Appropriate Cuffed Endotracheal Tube |
| Geon Ho Lee1, Young Ju Suh2, Jin Hui Paik1, Hyun Min Jung1, Ah Jin Kim1, Ji Hye Kim1 |
1Department of Emergency Medicine, College of Medicine, Inha University, Incheon, Korea
2, Department of Biomedical Sciences, College of Medicine, Inha University, Incheon, Korea |
| Correspondence |
Ji Hye Kim ,Tel: 032-890-2312, Fax: 032-890-2314, Email: ziihye@inha.ac.kr,
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Received: June 29, 2016; Revised: June 30, 2016 Accepted: July 27, 2016. Published online: October 30, 2016. |
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| ABSTRACT |
Purpose:
It has been established that the subglottic transverse diameter (SD-T) is the narrowest portion of the pediatric airway. In this study, we aimed to measure SD-T using computed tomography (CT) among Korean pediatrics, and compare and verify the measured SD-T with several formulas for appropriate size of the cuffed endotracheal tube (ETT) in pediatrics.
Method:
This is a retrospective study of 364 children from 0 month to 10 years undergoing facial CT scan. The CT scans were performed in children with spontaneous respiration. We obtained SD-T by these CT scans, and compared them with the Motoyama’s formula [internal diameter (ID, mm)=(age/4)+3.5], the formula by Khine et al [ID (mm)= (age/4)+3.0], and the formula by Kim et al [outer diameter (OD, mm)=0.01×age (month)+0.02×height (cm)+3.3]. The obtained ID by these formulas was converted to correspond with OD.
Results:
SD-T had a strong association with age (Estimate=0.029, R2=0.853, p<0.001), weight (Estimate=0.108, R2= 0.698, p<0.001), and height (Estimate=0.048, R2=0.854, p<0.001), according to a linear regression analysis. There was no difference of SD-T between males and females (p=0.636). The intraclass coefficients of OD by the Motoyama’s formula and the formula by Khine et al with OD of the cuffed ETT by measured SD-T were high (0.910, p<0.001, 0.897, p<0.001).
Conclusion:
Age based formulas for the appropriate cuffed ETT could be sufficient for emergency endotracheal intubation in Korean pediatrics. |
| Key words:
Computed tomography, Intubation, Pediatrics |
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