Neck Flexion and Extension Implicate the Tracheal Tube-tip Displacement in Children Undergoing Head and Neck Surgeries
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 172
- 试验地点
- 1
- 主要终点
- Distance of trachea carina (TC) to endotracheal tube (ETT) tip
研究概览
简要总结
This study evaluates the effect of head and neck movement in children on endotracheal tube (ETT) tip displacement undergoing head-and-neck surgeries. The tube-tip displacement will be measured using flexible fiberoptic bronchoscope.
详细描述
In clinical application, especially in head-and-neck surgeries, the operators often change the position of children's head-neck for easy operating. Flexing the head resulted in the ETT moving towards the carina, and extension resulted in the tube being displaced in the opposite direction. Head and neck movement change the length of trachea as well: extending the head resulted in the extension of trachea, while flexing resulted in the opposite. Serious complications following from head and neck movement, such as accidental extubation and endobronchial intubation, threat children's life.
In pediatric anesthesia, insertion depth (cm) of orotracheal intubation equals to age/2+12, according to classic intubation formulae. The ETT will be put in the depth calculated by the classic formulae under general anesthesia. The distance of ETT-tip displacement and the length change of trachea will be measured as the head and neck placed as follows: fully extended, neutral position, or fully flexed. These three head and neck positions imitate the head-neck movement during those head-and-neck surgeries.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 2 Years 至 14 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •subject has elective head-and-neck surgery schedule
- •subject will have orotracheal intubation under general anesthesia
排除标准
- •subject has malformations of the trachea or bronchus on chest X-ray
- •subject has spinal deformity
- •subject has difficulties in neck flexion or extension
- •subject has neck pain
结局指标
主要结局
Distance of trachea carina (TC) to endotracheal tube (ETT) tip
时间窗: 10min (time that the measurement need)
Measure the distance between trachea carina to the tip of ETT in three different neck-head positions: fully flexion, neutral positon and fully extension.
次要结局
- Distance of tracheal length(10min (time that the measurement need))
- Serious complication of unexpected displacement of the endotracheal tube: accidental extubation(intraoperative)
- Serious complication of unexpected displacement of the endotracheal tube: endobronchial intubation.(intraoperative)
研究者
Yan Siyi
Attending Doctor
Beijing Tsinghua Chang Gung Hospital