The Optimal Endotracheal Tube Cuff Position in Pediatric Patients

NCT ID: NCT06142149

Last Updated: 2023-11-28

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

RECRUITING

Clinical Phase

NA

Total Enrollment

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-16

Study Completion Date

2025-03-31

Brief Summary

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A. The hypothesis of this study is "Airway ultrasound will be superior to the conventional methods of auscultation and palpation in confirming proper positioning of the endotracheal tube in children undergoing endotracheal intubation with an endotracheal tube with cuff".

B. The purpose of this study is to determine the utility of airway ultrasound in confirming proper positioning of the endotracheal tube.

C. In addition, we would like to suggest what criteria should be used when using airway ultrasound to determine the fixed position of an endotracheal tube.

Detailed Description

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1. Obtain consent from the guardian of the target patient before surgery and perform randomization.
2. After entering the operating room, attach equipment for electrocardiogram, non-invasive blood pressure, peripheral oxygen saturation, anesthesia depth monitoring, and neuromuscular blockade monitoring.
3. Prepare the endotracheal tube according to the patient's age. 6 months to 18 months: internal diameter 3.5 18 months to 2 years: internal diameter 3.5 or 4.0 2-4 years: internal diameter 4.0 4 to 5 years: internal diameter 4.5 5 years and older: Age/4 + 3.5
4. When sufficient neuromuscular blockade is achieved after infusion of neuromuscular blocking agents, after inserting the endotracheal tube, check the position of the endotracheal tube according to the assigned group, fix the endotracheal tube in consideration of changes in posture during surgery, and record its depth.

Ultrasound group A. During tracheal intubation using a video laryngoscope, the endotracheal tube is stopped when the endotracheal tube cuff passes through the vocal cord.

B. Use ultrasound to check the position of the endotracheal tube cuff, check its movement according to the surgical position, and position the cuff according to the size of the endotracheal tube as follows.
* internal diameter 3.5, internal diameter 4.0: The cuff is positioned 0.5 cm below the lower margin of the cricoid cartilage.
* internal diameter 4.5, internal diameter 5.0: The cuff is positioned 1 cm below the lower margin of the cricoid cartilage.

C. In the final position, check for bilateral lung movement (lung sliding sign) using lung ultrasound.

D. Record the depth of fixation of the endotracheal tube.

Conventional Group A. During tracheal intubation with video laryngoscope, stop the endotracheal tube when the cuff of the endotracheal tube passes through the vocal cords, and confirm that the cuff of the endotracheal tube is palpable at the suprasternal notch.

B. Adjust the position of the endotracheal tube to account for movement in the surgical position and confirm that the endotracheal tube cuff is palpable at the suprasternal notch in the final position for surgery.

C. Confirm that bilateral lung sounds are audible through auscultation and secure the endotracheal tube.

D. Record the depth of endotracheal tube placement.
5. After the end of surgery and before awakening the patient, check the position of the endotracheal tube cuff using ultrasound.

Record how far the proximal margin of the endotracheal tube cuff is from the lower margin of the cricoid and how it relates to surrounding structures (1st tracheal ring, 2nd tracheal ring, 3rd tracheal ring, below the 3rd tracheal ring, above the cricoid level).

Check the movement of both lungs (sliding sign) using lung ultrasound.

Conditions

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Intubation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Ultrasound group

Use ultrasound to check the position of the endotracheal tube cuff, check its movement according to the surgical position, and position the cuff according to the size of the endotracheal tube.

Group Type EXPERIMENTAL

ultrasonographic evaluation

Intervention Type PROCEDURE

Screen the front of neck using ultrasound

Conventional group

Adjust the position of the endotracheal tube to account for movement in the surgical position and confirm that the endotracheal tube air sac is palpable at the suprasternal notch in the final position for surgery.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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ultrasonographic evaluation

Screen the front of neck using ultrasound

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Pediatric patients ages 6 months to 7 years who are scheduled to have an endotracheal tube inserted for facial or intraoral surgery.

Exclusion Criteria

* When difficult intubation is anticipated
* If the patient has deformities such as facial asymmetry due to congenital causes such as genetic diseases or acquired causes such as accidents.
* If the patient or guardian does not agree to participate in the study.
* Other cases deemed unsuitable by the researcher
Minimum Eligible Age

6 Months

Maximum Eligible Age

7 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Seoul National University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Eun-hee Kim

Clinical associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Eun-Hee Kim, M.D., Ph.D.

Role: STUDY_CHAIR

Seoul National University Hospital

Locations

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Seoul National University Children's Hospital

Seoul, , South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Eun-Hee Kim, M.D., Ph.D.

Role: CONTACT

+82-2-2072-3664

Facility Contacts

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Eun-Hee Kim, M.D., Ph.D.

Role: primary

+82-2-2072-3664

Other Identifiers

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2308-112-1459

Identifier Type: -

Identifier Source: org_study_id