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New Formula for Depth of Insertion of Endotracheal Tube in Children: A Prospective Observational Study

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Abstract

Objectives

To assess the correct placement of endotracheal tube (ETT) by confirming it with a flexible fiberoptic bronchoscope (FOB), to propose a new formula that would be suitable for Indian children, and to assess the movement of the ETT tip during neck flexion and extension.

Methods

A total of 76 patients were included in the study between the age of 2 and 10 y. Depth of ETT insertion was assessed using FOB. ETT migration due to changes in head and neck position was also assessed.

Results

It was observed that 6 out of 76 children had endobronchial/at carina position of ETT after the initial insertion as per the black line guidance in the neutral position. While the incidence was 23, 36, and 36, respectively as per Cole, weight-, and height-based formula.

Conclusion

The existing formulae are not suitable for Indian children as their physical stature is different from other ethnic populations. Therefore, the authors suggest a new formula [(Age/2) + 10 cm] for depth of ETT insertion for children of the authors’ geographical area.

Trial Registration

CTRI/2015/06/005871.

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Acknowledgements

The authors extend their sincere gratitude to Prof. Umesh Goneppanavar for his invaluable contribution to the contrivance/formulation of this study.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India

    Priya Logia

  2. Department of Anesthesiology, Sree Balaji Medical College & Hospital, BIHER, Chennai, Tamil Nadu, 600044, India

    Annu Theagrajan & Raghuraman M.S.

  3. Department of Anesthesiology, Kasturba Medical College, MAHE, Manipal, Karnataka, India

    Manjunath Prabhu

Authors
  1. Priya Logia
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  2. Annu Theagrajan
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  3. Raghuraman M.S.
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  4. Manjunath Prabhu
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Contributions

PL, MP: Concept; PL: Data collection; PL, AT, RMS, MP drafted and revised the manuscript. All authors approved the final version of manuscript. MP will act as the guarantor for this paper.

Corresponding author

Correspondence to Raghuraman M.S..

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Logia, P., Theagrajan, A., M.S., R. et al. New Formula for Depth of Insertion of Endotracheal Tube in Children: A Prospective Observational Study. Indian J Pediatr 91, 125–130 (2024). https://doi.org/10.1007/s12098-022-04206-z

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  • DOI: https://doi.org/10.1007/s12098-022-04206-z

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