The Optimal Endotracheal Tube Cuff Position in Pediatric Patients
NCT ID: NCT06142149
Last Updated: 2023-11-28
Study Results
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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RECRUITING
NA
62 participants
INTERVENTIONAL
2023-11-16
2025-03-31
Brief Summary
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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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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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Study Design
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RANDOMIZED
PARALLEL
DIAGNOSTIC
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.
ultrasonographic evaluation
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.
No interventions assigned to this group
Interventions
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ultrasonographic evaluation
Screen the front of neck using ultrasound
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
* 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
6 Months
7 Years
ALL
No
Sponsors
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Seoul National University Hospital
OTHER
Responsible Party
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Eun-hee Kim
Clinical associate professor
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
Countries
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Central Contacts
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Facility Contacts
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Other Identifiers
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2308-112-1459
Identifier Type: -
Identifier Source: org_study_id