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J Korean Soc Emerg Med > Volume 27(5); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(5): 450-457.
한국 소아에서 컴퓨터 단층 촬영 영상을 이용한 성문 하 가로지름 측정값과 커프가 있는 기관내관의 크기 결정을 위한 공식들의 비교
이건호1, 서영주2, 백진휘1, 정현민1, 김아진1, 김지혜1
1인하대학교 의과대학 응급의학교실
2인하대학교 의과대학 의생명과학교실
The Measurement of Korean Pediatric Subglottic Transverse Diameter Using Computed Tomography Imaging and Validation of the Formulas for the Appropriate Cuffed Endotracheal Tube
Geon Ho Lee1, Young Ju Suh2, Jin Hui Paik1, Hyun Min Jung1, Ah Jin Kim1, Ji Hye Kim1
1Department of Emergency Medicine, College of Medicine, Inha University, Incheon, Korea
2, Department of Biomedical Sciences, College of Medicine, Inha University, Incheon, Korea
Correspondence  Ji Hye Kim ,Tel: 032-890-2312, Fax: 032-890-2314, Email: ziihye@inha.ac.kr,
Received: June 29, 2016; Revised: June 30, 2016   Accepted: July 27, 2016.  Published online: October 30, 2016.
ABSTRACT
Purpose:
It has been established that the subglottic transverse diameter (SD-T) is the narrowest portion of the pediatric airway. In this study, we aimed to measure SD-T using computed tomography (CT) among Korean pediatrics, and compare and verify the measured SD-T with several formulas for appropriate size of the cuffed endotracheal tube (ETT) in pediatrics.
Method:
This is a retrospective study of 364 children from 0 month to 10 years undergoing facial CT scan. The CT scans were performed in children with spontaneous respiration. We obtained SD-T by these CT scans, and compared them with the Motoyama’s formula [internal diameter (ID, mm)=(age/4)+3.5], the formula by Khine et al [ID (mm)= (age/4)+3.0], and the formula by Kim et al [outer diameter (OD, mm)=0.01×age (month)+0.02×height (cm)+3.3]. The obtained ID by these formulas was converted to correspond with OD.
Results:
SD-T had a strong association with age (Estimate=0.029, R2=0.853, p<0.001), weight (Estimate=0.108, R2= 0.698, p<0.001), and height (Estimate=0.048, R2=0.854, p<0.001), according to a linear regression analysis. There was no difference of SD-T between males and females (p=0.636). The intraclass coefficients of OD by the Motoyama’s formula and the formula by Khine et al with OD of the cuffed ETT by measured SD-T were high (0.910, p<0.001, 0.897, p<0.001).
Conclusion:
Age based formulas for the appropriate cuffed ETT could be sufficient for emergency endotracheal intubation in Korean pediatrics.
Key words: Computed tomography, Intubation, Pediatrics
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