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J Korean Soc Emerg Med > Volume 28(1); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(1): 26-31.
자기공명상을 이용한 소아의 적정 기관삽관 깊이 결정을 위한 새로운 공식
최은호, 오성범, 김태훈
단국대학교 의과대학 응급의학교실
A New Formula for Optimal Pediatric Endotracheal Tube Depth by Magnetic Resonance Imaging: Limited Study
Eun Ho Choi, Seong Beom Oh, Tae Hun Kim
Department of Emergency Medicine, Dankook University College of Medicine, Cheonan, Korea
Correspondence  Seong Beom Oh ,Tel: 041-550-7241, Fax: 041-550-7054, Email: holytiger@hanmail.net ,
Received: August 31, 2016; Revised: September 2, 2016   Accepted: October 12, 2016.  Published online: February 28, 2017.
ABSTRACT
Purpose:
The aim of this study is to propose a new, simplified formula using an upper incisor-sternal notch (UI-SN) to predict the airway length of optimal positioning of the endotracheal tube via a midsagittal magnetic resonance imaging (MRI) in pediatric patients.
Method:
Between August 2000 and September 2014, a total of 56 pediatric patients (under 8 years old) who underwent MRI for C-spine or whole spine were included for analysis. Variables, such as curved airway length from upper incisor to carina (UI-C), straight length from upper incisor to sternal notch (UI-SN), and from the clivus to sternal notch (C-SN), were measured. Linear regression was used to analyze the relationship among these variables.
Results:
The average age was 3.5±2.6, and there were 30 (53.6%) males. The mean airway length for UI-C and UI-SN was 16.0±2.8 and 8.8±2.1 cm, respectively. There was a close linear correlation between UI-C and UI-SN (p<0.001). By linear regression, a formula was obtained as UI-C (cm)=1.26×UI-SN (cm)+5.0 (R2=0.873).
Conclusion:
The airway length from the upper incisor to the carina with the head placed in neutral position can be well predicted by a straight length from the upper incisor to the sternal notch. The proposed simplified formula (UI-C=1.26× UI-SN+5, cm) can provide good guidance in determining the optimal positioning of endotracheal tube in pediatric patients.
Key words: Intubation, Pediatrics, Magnetic resonance imaging
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