usage of ultrasound to determine size of paediatric endotracheal tube

Phase 3

Not yet recruiting

Conditions: Other general symptoms and signs,

Registration Number: CTRI/2023/12/060899

Lead Sponsor: dr charulata deshpande

Brief Summary: Choosing an appropriate sized Endotracheal Tube (ETT) is significant in paediatric patients. In neonatal period, the trachea resembles a funnel, tapered downward, maximally narrowed at the level of cricoid cartilage. However, in the later stages, it takes the shape of a cylinder. A large-sized ETT leads to trauma of the surrounding structures and subsequent airway edema, postextubation stridor, and subglottic stenosis in few. On the other hand, a smaller ETT would result in leakage, inadequate ventilation, increased resistance flow, and risk of aspiration, poor monitoring of end tidal gases. Both the cases demand an immediate tube change, complicating the situation as these patients having lower lung volume reserves tend to desaturate fast.A list of physical indices-based formulae such as age based, height based, Modified Coleâ€™s formula for uncuffed tubes and Khineâ€™s formula for cuffed tube, diameter of the distal digit of the little finger, have been used traditionally to determine the most suited size of the ETT. However, these assessments have failed to justify the purpose many a times leading to repeated laryngoscopy and tube change at time of intubation. Age based formulae are most commonly used and show a variable success rate ranging from 47% to 77%. During recent years, several studies explored the possibility of utilising ultrasound guided ETT size selection in paediatric age group. The advantages of using US for measuring airway diameters are the following: it is a minimally invasive technique, is easily available at the bedside, and has proven value for assessing airway anatomy. In addition, it can also assess the airway for any other abnormality before attempting intubation. All the previous studies were performed in a western population. It is well known that ultrasound measurements vary significantly depending on the ethnicity of the child, hence the need for this study. With the increase in availability and acquaintance of the modern ultrasound devices to the anaesthesiologists, the complication rate is expected to see a downward trend with a promise toward better outcome.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 35

Inclusion Criteria

Weight more than 10kg.
Patients requiring orotracheal intubation for anaesthesia.
Patients willing to give informed written consent.
American Society of Anaesthesiologists physical Status I and II patients.

Exclusion Criteria

Patient refusal.
Emergency surgery.
Head and neck anatomical abnormality.
Restricted mouth opening.
Soft tissue swelling over neck.
Any other contraindication to intubation.
Patients requiring rapid sequence intubation.
Uncooperative patients.
previous histories of tracheal and laryngeal pathologies, such as tracheostomy; previous surgery involving upper airway and any obvious scars.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
to assess the SGD ultrasongraphically and compare it with age based formulae;as a true reflection of the correct ETT size	its a single point measurement, which be less than a minute after giving muscle relaxant

Secondary Outcome Measures

Name	Time	Method
-To assess the usefulness of US by reintubation attempts with different size of ETT due to unacceptable leak.	-To compare US predicted ETT size with age based formulae

Trial Locations

Locations (1): TOPIWALA NATIONAL MEDICAL COLLEGE AND BYL NAIR CHARITABLE HOSPITAL
🇮🇳
(Suburban), MAHARASHTRA, India
TOPIWALA NATIONAL MEDICAL COLLEGE AND BYL NAIR CHARITABLE HOSPITAL
🇮🇳(Suburban), MAHARASHTRA, India
dr jain roma
Principal investigator
8097671274
jain.roma6@gmail.com