Comparison of Endotracheal Tube Size Estimated by Ultrasonography and Age-based Formula for Choosing Appropriate Size in Pediatric Patients
Year: 2025
Type: article
Abstract: INTRODUCTION: Pediatric endotracheal intubation is challenging due to airway anatomical differences. Accurate endotracheal tube (ETT) sizing is crucial for effective ventilation and preventing complications. Traditional age, weight, or height-based methods are often unreliable, leading to multiple attempts. Ultrasonography (USG), by measuring cricoid diameter, offers a more precise alternative. This study compares USG with age-based formulae in selecting the appropriate ETT size. MATERIALS AND METHODS: This prospective study involved 96 pediatric patients (2-12 years) undergoing elective surgery. Group A used the Penlington formula, whereas Group B used USG-guided ETT selection. The subglottic diameter was measured using USG, and the closest matching ETT was chosen. An independent anesthesiologist performed an air leak test to assess ETT suitability. RESULTS: USG-based selection (Group B) resulted in fewer ETT exchanges and higher rates of correctly sized tubes compared to the Penlington formula ( P = 0.003). Group A significantly underestimated ETT size ( P = 0.001), whereas Group B showed a minor overestimation ( P = 0.04). DISCUSSION: USG provided a more precise method for ETT selection, reducing repeated intubations and associated risks. CONCLUSION: USG-based cricoid diameter estimation is a more reliable method for determining ETT size than traditional formulas, reducing tube exchanges and enhancing patient safety.
Source: Annals of African Medicine
Authors: Anjana Kashyap, Madhava Pai Kanhangad
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4414085603