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Elongation of the trachea during neck extension in children: implications of the safety of endotracheal tubes

Cited 23 time in Web of Science Cited 33 time in Scopus
Authors
Kim, Jin-Hee; Ro, Young-Jin; Min, Seong-Won; Kim, Chong-Soo; Kim, Seong-Deok; Lee, Jun Ho; Bahk, Jae-Hyon
Issue Date
2005-09-30
Publisher
Elsevier
Citation
Anesth Analg. 2005 Oct;101(4):974-7, table of contents.
Keywords
ChildChild, PreschoolFemaleHumansIntubation, Intratracheal/adverse effects/instrumentation/*methodsMaleNeckSafetyTrachea/*anatomy & histology
Abstract
During neck extension, the changes in distance between endotracheal tube (ETT) tip and carina may not be equal to the changes in distance between vocal cords and ETT tip because of tracheal elongation. These distances are directly related to extubation risk. Using a fiberoptic bronchoscope, the distance between ETT tip and carina was measured in the neutral position after full extension of the neck in 25 children (2-8 yr old) scheduled for elective surgery under general anesthesia. The tracheal length was then measured in the neutral position and after full extension. The distance between vocal cords and ETT tip was calculated as the tracheal length minus the distance between ETT tip and carina. After full extension, the tracheal length (7.97 +/- 0.85 cm) was increased by 0.95 +/- 0.43 cm, and the change in distance between vocal cords and ETT tip was -1.08 +/- 0.47 cm, whereas the change in distance between ETT tip and carina was 2.02 +/- 0.58 cm. These results suggest that neck extension actually displaces the ETT tip to the vocal cords, increasing the risk of tracheal extubation in older children, although the actual displacement of ETT tip to vocal cords is reduced by tracheal lengthening. IMPLICATIONS: The distance between endotracheal tube tip and vocal cords is directly related to the risk of exubation. Despite tracheal elongation, neck extension actually displaced the endotracheal tube tip to the vocal cords in older children.
ISSN
0003-2999 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16192505

http://hdl.handle.net/10371/26876
DOI
https://doi.org/10.1213/01.ane.0000169330.92707.1e
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College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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