Abstract

Endotracheal intubation is a critical procedure in pediatric patients, necessitating precise selection of the appropriate endotracheal tube (ETT) size. Traditional age-based formulas have limitations, prompting the exploration of ultrasound-based techniques for ETT size prediction. This study aimed to compare the accuracy of ultrasound-based techniques with age-based formulas in predicting ETT size in one-year-old pediatric patients. Materials and Methods: A hospital-based randomized controlled trial was conducted involving pediatric patients aged 12 to 24 months. Participants were randomly assigned to either the ultrasound group or the age-based formula group. Ultrasound was used to measure airway dimensions in the ultrasound group, while age-based formulas were employed in the control group. The primary outcome was the accuracy of ETT size prediction, assessed by comparing predicted and actual ETT sizes. Secondary outcomes included intraoperative complications and adverse events. Results: The ultrasound group demonstrated higher accuracy in predicting ETT size (95%) compared to the age-based formula group (85%). Intraoperative complications, including malpositioning, airway trauma, and difficulty in ventilation, were slightly lower in the ultrasound group. Ultrasonographic measurements showed statistically significant differences in subglottic diameter. The distribution of ETT sizes used was similar between groups. Adverse event rates were comparable between the two groups. Conclusion: Ultrasound-based techniques offer superior accuracy in predicting ETT size compared to age-based formulas in one-year-old pediatric patients. This approach may reduce intraoperative complications and improve safety outcomes during endotracheal intubation. Incorporating ultrasound into pediatric airway management protocols holds promise for enhancing patient care and optimizing procedural outcomes

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