Weiss M. , Gerber A.C. , Dullenkopf A. British Journal of Anaesthesia

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Presentation transcript:

Appropriate placement of intubation depth marks in a new cuffed paediatric tracheal tube† Weiss M. , Gerber A.C. , Dullenkopf A. British Journal of Anaesthesia Volume 94, Issue 1, Pages 80-87 (January 2005) DOI: 10.1093/bja/aeh294 Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

Fig 1 (a) Microcuff paediatric tracheal tube with high volume-low pressure cuff, semi-circular intubation depth mark, cuff-free subglottic tube shaft. (b) Glottic intubation depth mark placed between the vocal cords. The four points can be used to estimate the distance to the intubation depth mark in case of an obstructed view to the vocal cords or correction of too deep tracheal tube insertion. British Journal of Anaesthesia 2005 94, 80-87DOI: (10.1093/bja/aeh294) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

Fig 2 Measurement of the distance from tube tip to carina is performed using the fibreoptic drawback technique: a clip is placed on the fibrescope at the level of the swivel adapter as the crest of the carina is just visualized on the monitor (left). Then the endoscope is drawn back until the proximal tube tip (arrow) is just visualized, and the distance between the clip and the level of the swivel adapter is measured (right). British Journal of Anaesthesia 2005 94, 80-87DOI: (10.1093/bja/aeh294) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

Fig 3 Fibrebronchoscopically measured tube tip to carina distances with indicated margin of safety for endobronchial intubation during head–neck flexion. The thin line indicates caudal tube tip displacement in case of head–neck flexion (neonate 8 mm; adult patient 19 mm).101112–13 (a) Tracheal tube tip position above the tracheal carina based on intubation depth markings (n=250). (b and c) Formula-based corrected tube tip position above the carina in children aged ≥2 yr (n=175). (b) Oral tube insertion depth (cm)=11.5+(age [yr]×0.5); (c) oral tube insertion depth (cm)=12.0+(age [yr]×0.5). Negative correction values indicate a new cuff position in the subglottic area or even between the vocal cords. British Journal of Anaesthesia 2005 94, 80-87DOI: (10.1093/bja/aeh294) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions

Fig 4 Linear/logarithmic regression plots for the comparison of tube insertion depth at the lateral corner of the mouth based on intubation depth marks and calculated tracheal length with age, height, and weight (n=250). British Journal of Anaesthesia 2005 94, 80-87DOI: (10.1093/bja/aeh294) Copyright © 2005 British Journal of Anaesthesia Terms and Conditions