Comparison of Ultrasonographic Estimation of Endotracheal Tube Size with Age-Based Formula in Pediatric Patients a cross sectional randomized study.

Abstract

Background and Aim of study: Endotracheal intubation in pediatric patients might be challenging due to
anatomical variances. One problem is selecting the appropriate size of endotracheal tube for intubation
(1). Choosing the right Endotracheal tube size is crucial, especially for young patients. Using an
incorrectly sized ETT can have serious consequences, including death. Various methods are used to
estimate correct ETT size based on patient demographics, such as age, weight, and height. Some
anesthesiologists use the diameter of the little finger for crude estimation. However, these methods have
poor agreement with the actual ETT size appropriate for the patient. This study evaluated the efficacy of
ultrasonographic assessment of ETT size to the usual age-based calculation.
Material and Method: This cross sectional randomised study was done on 72 patients undergoing elective
procedures at the Department of Anaesthesiology, Integral Institute of Medical Sciences, Lucknow,
between September 2022 and March 2024, after institutional ethics committee permission.Patients were
separated into two groups of 36 each. Group A's ETT size was approximated using Pennington's method.
Group B where ETT size was assessed by ultrasonography. The results were evaluated using descriptive
statistics and compared between groups. Categorical data were summarized as proportions and
percentages (%), whereas discrete data were reported as mean ± SD.
Results: Insertion of ETT estimated by ultrasound had greater rate of successful insertion in first attempt,
easy insertion and less postoperative complications when compared to ETT size estimated by
Penlington’s formula