Prediction of endotracheal tube size using a printed three-dimensional airway model in pediatric patients with congenital heart disease: a prospective, single-center, single-group study.
Prediction of endotracheal tube size using a printed three-dimensional airway model in pediatric patients with congenital heart disease: a prospective, single-center, single-group study.
复制标题
使用印刷的三维气道模型在先天性心脏病患者中预测气管管的大小：一项前瞻性，单中心，单组研究。
DOI：
10.4097/kja.21114
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发表时间：
2021-08
影响因子：
2.9
通讯作者：
Kim HY
中科院分区：
文献类型：
--
作者：
Park S;Ahn J;Yoon SU;Choo KS;Kim HJ;Chung M;Kim HY
为了确定儿科患者气管插管时气管插管（ETT）的正确尺寸，研究了新方法。虽然三维（3D）打印技术在手术领域取得了成功，但在麻醉领域的研究并不多。本研究的目的是评价3D气道模型预测正确ETT尺寸的准确性，并将结果与儿科患者中基于年龄的传统公式进行比较。35例6岁以下的儿童患者计划接受先天性心脏病手术。在麻醉前阶段，使用3D转换程序将患者的计算机断层扫描（CT）图像转换为标准三角形语言（STL）文件。使用熔融沉积建模（FDM）型3D打印机打印从声门下到上隆突的3D气道模型。通过将各种尺寸的套囊ETT插入打印的3D气道模型来选择ETT尺寸。3D方法在35名儿科患者中的21名（60%）中选择了正确的ETT尺寸，而基于年龄的公式在9名患者中选择了正确的ETT尺寸（26%）。使用打印的3D气道模型预测ETT的正确尺寸比基于年龄的公式显示出更好的结果。这表明，使用打印的3D气道模型选择ETT尺寸可能有助于减少先天性心脏病患者和/或生长发育异常患者的重新插管尝试和并发症。
To determine the correct size of endotracheal tubes (ETTs) for endotracheal intubation of pediatric patients, new methods have been investigated. Although the three-dimensional (3D) printing technology has been successful in the field of surgery, there are not many studies in the field of anesthesia. The purpose of this study was to evaluate the accuracy of a 3D airway model for prediction of the correct ETT size, and compare the results with a conventional age-based formula in pediatric patients. Thirty-five pediatric patients under six years of age who were scheduled for congenital heart surgery were enrolled. In the pre-anesthetic period, the patient’s computed tomography (CT) images were converted to Standard Triangle Language (STL) files using the 3D conversion program. A Fused Deposition Modelling (FDM) type 3D printer was used to print 3D airway models from the sub-glottis to the upper carina. ETT size was selected by inserting various sized cuffed-ETTs to a printed 3D airway model. The 3D method selected the correct ETT size in 21 out of 35 pediatric patients (60%), whereas the age-based formula selected the correct ETT size in 9 patients (26%). Prediction of the correct size of ETTs using a printed 3D airway model demonstrated better results than the age-based formula. This suggests that the selection of ETT size using a printed 3D airway model may be feasible for helping minimize re-intubation attempts and complications in patients with congenital heart disease and/or those with an abnormal range of growth and development.