Comparison of the Effectiveness of Tracheal Ultrasonography and Conventional Techniques for the Determination of Endotracheal Tube Diameter in Pediatric Patients Undergoing Cardiac Surgeries

Abstract

Introduction: In this study, we aimed to compare the effectiveness of tracheal ultrasonography (t-USG), a new application, with the frequently used techniques for the determination of endotracheal tube (ETT) diameter and the contribution of it to patient safety. Patients and Methods: t-USG was performed by a radiologist 1 day before the surgery, and the tracheal diameter was measured from the subglottic level. On the day of the operation, the ETT diameter was calculated for each patient according to the Cole's formula, which is the most frequently used formula based on age. Demographic data of the patients, applied ETT sizes, appropriate ETT numbers according to Cole's formula, and the preoperatively measured ETT numbers by t-USG were compared. Results: From the total, 53% of the patients (n= 16) were male, 47% of them (n= 14) were female, and the average age was 10.9 ± 5.7 months. Further, 37% of the patients (n= 11) had cyanotic congenital heart defects (CHD), whereas 63% (n= 19) had acyanotic CHD. The average ETT diameter measured using t-USG was 4.52 ± 0.52 mm, the average ETT diameter measured by Cole's formula was 4.23 ± 0.12 mm, and the average ETT diameter that was clinically applied was 4.45 ± 0.50 mm. Measurements obtained by t-USG were significantly higher than the measurements calculated by Cole's formula (p< 0.05). However, there was no statistically significant difference between the clinically obtained measurements and the measurements calculated by both t-USG and Cole's formula (p> 0.05). A positive, statistically significant, and intermediate correlation was found between the ETT diameters calculated by t-USG and Cole's formula (r= 0.48, p< 0.01).Conclusion: Performing t-USG preoperatively for pediatric patients in the age range of 0-2 years is more effective, reliable, and non-invasive for determining the ETT diameter than conventional techniques.