Ultrasonography vs Cole Formula to Predict Endotracheal Tube Diameter

NCT ID: NCT02754531

Last Updated: 2017-03-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-05-31

Study Completion Date

2016-07-31

Brief Summary

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This study aims to compare the accuracy of measurement between ultrasonography and Cole formula in predicting uncuffed endotracheal tube diameter.

Detailed Description

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Approval from Ethical Committee of Faculty of Medicine Universitas Indonesia was acquired prior conducting the study. Subjects were given informed consent before enrolling the study. Non-invasive blood pressure (NIBP) monitor, ECG and pulse-oximeter was set on the subjects in the operation room. The uncuffed endotracheal tube (ETT) diameter predictions were measured firstly using ultrasonography (USG), then with Cole formula. After that, polyvinyl chloride (Mallinckrodt) ETT intubation with Cole diameter measurement was inserted using direct laryngoscopy. If the ETT was too small, use a 0.5 mm bigger ETT than the prediction diameter, if it too big, use a 0.5 mm smaller ETT than the prediction diameter. Reintubation and measurements using both methods were recorded. If bradycardia or desaturation happened, positive pressure ventilation, 100% oxygen, atropine 0,01-0,02 mg/kg, adrenaline 0,01 mg/kg could be given. Data was analyzed using SPSS using Bivariat Chi-square test or Fisher Exact Test (categorical comparative analytical study).

Conditions

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General Anesthesia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Subjects

USG was used to measure the internal transversal subglottic diameter on the crichoid cartilago level while the head was in sniffing position. After USG measurement was recorded, Cole formula was used to measure internal diameter of uncuffed endotracheal tube.

Group Type EXPERIMENTAL

USG

Intervention Type DEVICE

USG used was SonoSite® M-Turbo Bothell, WA, USA, probe linear (Array HFL 38 frekuensi 6-13 MHz). Internal subglottic diameter equals external diameter of the uncuffed endotracheal tube or trachea diameter, result rounded to the smallest uncuffed endotracheal tube size.

Cole Formula

Intervention Type OTHER

Internal diameter of the uncuffed endotracheal tube equals (age in years/4) + 4mm.

Interventions

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USG

USG used was SonoSite® M-Turbo Bothell, WA, USA, probe linear (Array HFL 38 frekuensi 6-13 MHz). Internal subglottic diameter equals external diameter of the uncuffed endotracheal tube or trachea diameter, result rounded to the smallest uncuffed endotracheal tube size.

Intervention Type DEVICE

Cole Formula

Internal diameter of the uncuffed endotracheal tube equals (age in years/4) + 4mm.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Subjects aged 1-6 years old, Malayan race, planned to undergo elective surgery with general anesthesia with intubation
* Subjects with ASA status I-II
* Cooperative subjects
* Subjects whose parents had signed the informed consent

Exclusion Criteria

* Subjects with allergies to Ultrasonography jelly
* Subjects with difficult airway
* Subjects with mass in the neck area
* Subjects with respiratory diseases
* Subjects with growth \& development disorders
* Subjects with malnutrition (\<5% percentile) and obesity (\>95% percentile).

Drop out criteria:

* Subjects with cardiorespiratory disorder during intubation
* Subjects who were failed to be intubated twice.
Minimum Eligible Age

1 Year

Maximum Eligible Age

6 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Indonesia University

OTHER

Sponsor Role lead

Responsible Party

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Dr. dr. Aida Rosita Tantri SpAn-KA

Consultant, Anesthesiologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Aida R Tantri, Consultant

Role: PRINCIPAL_INVESTIGATOR

Indonesia University

Locations

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Cipto Mangunkusumo Cental National Hospital

Jakarta, DKI Jakarta, Indonesia

Site Status

Countries

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Indonesia

References

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Gupta K, Gupta PK, Rastogi B, Krishan A, Jain M, Garg G. Assessment of the subglottic region by ultrasonography for estimation of appropriate size endotracheal tube: A clinical prospective study. Anesth Essays Res. 2012 Jul-Dec;6(2):157-60. doi: 10.4103/0259-1162.108298.

Reference Type BACKGROUND
PMID: 25885609 (View on PubMed)

Park HP, Hwang JW, Lee JH, Nahm FS, Park SH, Oh AY, Jeon YT, Lim YJ. Predicting the appropriate uncuffed endotracheal tube size for children: a radiograph-based formula versus two age-based formulas. J Clin Anesth. 2013 Aug;25(5):384-387. doi: 10.1016/j.jclinane.2013.01.015. Epub 2013 Aug 17.

Reference Type BACKGROUND
PMID: 23965215 (View on PubMed)

COLE F. Pediatric formulas for the anesthesiologist. AMA J Dis Child. 1957 Dec;94(6):672-3. doi: 10.1001/archpedi.1957.04030070084009. No abstract available.

Reference Type BACKGROUND
PMID: 13478300 (View on PubMed)

Eipe N, Barrowman N, Writer H, Doherty D. A weight-based formula for tracheal tube size in children. Paediatr Anaesth. 2009 Apr;19(4):343-8. doi: 10.1111/j.1460-9592.2008.02916.x. Epub 2009 Jan 21.

Reference Type BACKGROUND
PMID: 19178655 (View on PubMed)

van den Berg AA, Mphanza T. Choice of tracheal tube size for children: finger size or age-related formula? Anaesthesia. 1997 Jul;52(7):701-3. doi: 10.1111/j.1365-2044.1997.az0130c.x.

Reference Type BACKGROUND
PMID: 9254579 (View on PubMed)

Shibasaki M, Nakajima Y, Ishii S, Shimizu F, Shime N, Sessler DI. Prediction of pediatric endotracheal tube size by ultrasonography. Anesthesiology. 2010 Oct;113(4):819-24. doi: 10.1097/ALN.0b013e3181ef6757.

Reference Type BACKGROUND
PMID: 20808208 (View on PubMed)

Bae JY, Byon HJ, Han SS, Kim HS, Kim JT. Usefulness of ultrasound for selecting a correctly sized uncuffed tracheal tube for paediatric patients. Anaesthesia. 2011 Nov;66(11):994-8. doi: 10.1111/j.1365-2044.2011.06900.x. Epub 2011 Sep 20.

Reference Type BACKGROUND
PMID: 21933159 (View on PubMed)

Schramm C, Knop J, Jensen K, Plaschke K. Role of ultrasound compared to age-related formulas for uncuffed endotracheal intubation in a pediatric population. Paediatr Anaesth. 2012 Aug;22(8):781-6. doi: 10.1111/j.1460-9592.2012.03889.x. Epub 2012 May 21.

Reference Type BACKGROUND
PMID: 22612446 (View on PubMed)

Delilkan AE. Choice of endotracheal tube in the Malaysian paediatric patient--a guide. Singapore Med J. 1973 Mar;14(1):26-8. No abstract available.

Reference Type BACKGROUND
PMID: 4713016 (View on PubMed)

Zahedi-Nejad N, Bakhshayesh-Karam M, Kahkoei S, Abbasi-Dezfoully A, Masjedi MR. Normal dimensions of trachea and two main bronchi in the Iranian population. Pol J Radiol. 2011 Oct;76(4):28-31.

Reference Type BACKGROUND
PMID: 22802851 (View on PubMed)

Mi W, Zhang C, Wang H, Cao J, Li C, Yang L, Guo F, Wang X, Yang T. Measurement and analysis of the tracheobronchial tree in Chinese population using computed tomography. PLoS One. 2015 Apr 20;10(4):e0123177. doi: 10.1371/journal.pone.0123177. eCollection 2015.

Reference Type BACKGROUND
PMID: 25894917 (View on PubMed)

Adewale L. Anatomy and assessment of the pediatric airway. Paediatr Anaesth. 2009 Jul;19 Suppl 1:1-8. doi: 10.1111/j.1460-9592.2009.03012.x.

Reference Type BACKGROUND
PMID: 19572839 (View on PubMed)

Prasad A, Yu E, Wong DT, Karkhanis R, Gullane P, Chan VW. Comparison of sonography and computed tomography as imaging tools for assessment of airway structures. J Ultrasound Med. 2011 Jul;30(7):965-72. doi: 10.7863/jum.2011.30.7.965.

Reference Type BACKGROUND
PMID: 21705729 (View on PubMed)

Singh M, Chin KJ, Chan VW, Wong DT, Prasad GA, Yu E. Use of sonography for airway assessment: an observational study. J Ultrasound Med. 2010 Jan;29(1):79-85. doi: 10.7863/jum.2010.29.1.79.

Reference Type BACKGROUND
PMID: 20040778 (View on PubMed)

Prasanna Kumar S, Ravikumar A. Biometric study of the internal dimensions of subglottis and upper trachea in adult Indian population. Indian J Otolaryngol Head Neck Surg. 2014 Jan;66(Suppl 1):261-6. doi: 10.1007/s12070-012-0477-x. Epub 2012 Jan 21.

Reference Type BACKGROUND
PMID: 24533395 (View on PubMed)

CROTEAU JR, COOK CD. Volume-pressure and length-tension measurements in human tracheal and bronchial segments. J Appl Physiol. 1961 Jan;16:170-2. doi: 10.1152/jappl.1961.16.1.170. No abstract available.

Reference Type BACKGROUND
PMID: 13696635 (View on PubMed)

Griscom NT, Wohl ME. Dimensions of the growing trachea related to age and gender. AJR Am J Roentgenol. 1986 Feb;146(2):233-7. doi: 10.2214/ajr.146.2.233.

Reference Type BACKGROUND
PMID: 3484568 (View on PubMed)

Related Links

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http://www.das.uk.com/

Black A, Flynn P, Popat M, Smith H, Thomas M, Wilkinson K. Unanticipated difficult tracheal intubation - during routine induction of anaesthesia in a child aged 1 to 8 years. 2015

Other Identifiers

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IndonesiaUAnes006

Identifier Type: -

Identifier Source: org_study_id

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