Sizes and depths of endotracheal tubes for cleft lip and palate children undergoing primary cheiloplasty and palatoplasty
Sizes and depths of endotracheal tubes for cleft lip and palate children undergoing primary cheiloplasty and palatoplasty
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DOI：
10.1111/j.1460-9592.2008.02668.x
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发表时间：
2008-09-01
影响因子：
1.7
通讯作者：
Sugiyama, Kazuna
中科院分区：
文献类型：
--
作者：
Kohjitani, Atsushi;Iwase, Yoko;Sugiyama, Kazuna
背景资料：唇腭裂儿童，一般有延迟的生长和发育，在婴儿早期未阐明适当的尺寸（内径）和插入深度的无套囊预成形气管插管：回顾性分析的尺寸和插入深度的气管插管的患者谁接受初级cheiloplasty和/或palatoplasty的年龄，身高和体重。在气道压力为15-20 cmH（2）O时，使用适当的漏气量确定插管尺寸。通过在几个插管深度听诊双侧呼吸音确认插管插入深度，将头端置于隆突上方1.5 cm处。所获得的数据集进行了比较，与以前发表的study.Results：分析的情况下，总数为236。平均年龄、身高和体重分别为327.4 ± 199.2天、69.7 ± 7.5 cm和8.2 ± 1.8 kg（平均值± SD）。唇腭裂患儿咽鼓管的长度和深度均小于正常儿童。预成型弯曲和插管插入深度之间的差异随着插管尺寸的增加而增加。目前的研究结果表明，这是合理的，适用于正常儿童的现有标准，如Motoyama的一般指南，预测管的大小和插入深度为日本唇腭裂儿童，并且使用无套囊的预成型气管内导管与支气管内插管的风险相关，该风险似乎随着年龄的增长而增加。
Background: Appropriate sizes (internal diameters) and insertion depths of uncuffed preformed endotracheal tubes in children with cleft lip and palate, who generally have delayed growth and development in early infancy have not been elucidated.Methods: The sizes and insertion depths of endotracheal tubes in patients who received primary cheiloplasty and/or palatoplasty in relation to age, height, and weight were retrospectively analyzed. Tube sizes were determined using an appropriate air leakage at an airway pressure of 15-20 cmH(2)O. Tube insertion depths were confirmed by auscultation of bilateral breathing sounds at several tube depths, placing the tip 1.5 cm above the carina. Obtained data sets were compared with previously published studies.Results: The number of cases analyzed was 236 in total. The mean age, height, and weight were 327.4 +/- 199.2 days, 69.7 +/- 7.5 cm, and 8.2 +/- 1.8 kg, respectively (mean +/- SD). Neither the tube size nor tube depth in cleft lip and palate children was smaller or shorter than those of normal subjects. Discrepancies between the preformed bend and the tube insertion depth increased as the tube size increased.Conclusions: The current findings suggest that it is reasonable to apply the currently available standards for normal children, e.g. Motoyama's general guide, to predict the tube size and insertion depth for Japanese cleft lip and palate children, and that the use of the uncuffed preformed endotracheal tube is associated with a risk of endobronchial intubation, which appears to increase with age.