한국 소아에서 컴퓨터 단층 촬영 영상을 이용한 성문 하 가로지름 측정값과 커프가 있는 기관내관의 크기 결정을 위한 공식들의 비교 (The Measurement of Korean Pediatric Subglottic Transverse Diameter Using Computed Tomography Imaging and Validation of the Formulas for the Appropriate Cuffed Endotracheal Tube)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 27권 / 5호 / 450 ~ 457페이지
· 저자명 : 이건호, 서영주, 백진휘, 정현민, 김아진, 김지혜

초록

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.
Methods: 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.

영어초록

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.
Methods: 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.

참고자료

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