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Pediatric patients are exposed to increased risk during general anesthesia. A myriad of problems can be encountered in the pediatric population by misplaced endotracheal tubes. Especially, during one-lung ventilation (OLV) a right-sided or left-sided tube is inserted to facilitate the surgery. However, inadvertent tube use, caused by misinterpretation of the distances of the trachea and the main bronchi, may cause unintended hypoxemia, postoperative atelectasis and even mortality.
In this study, investigators will measure the distance between distal margin of right lung upper lobe orifice-carina and carina-lip with the help of fiberoptic bronchoscopy (FOB).
In ASA-PS I-II-III children between 1-18 years of age who are orotracheally intubated for any reason, the fiber optic bronchoscope will be advanced in the tube and first the carina distance and then the carina to right upper bronchus distance will be measured.
Age, weight, height, body mass index (BMI), weight percentile, height percentile, comorbidities, ASA score, tube size, lip margin distance, right upper bronchus to carina distance and right upper lobe to carina distance/ Carina to-lip margin ratio will be recorded.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pediatric | FOB measurement of the distance between carina and right upper lobe bronchus and carina and labium oris in pediatric population |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FOB measurement | Procedure | A FOB will be inserted after anesthesia induction and the distances will be measured by direct observation via the bronchoscope. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Upper/Lower Airway Ratio | Ratio of the distance between labium oris to carina and carina to right upper lobe orifice | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation between patient characteristics and distances measured by FOB | Correlation between age, body mass index, gender, percentiles and the distance between labium oris to carina and carina to right upper lobe orifice | 1 day |
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Inclusion Criteria:
Exclusion Criteria:
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All patients undergoing general anesthesia via an endotracheal tube will be eligible for recruitment.
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| Name | Affiliation | Role |
|---|---|---|
| PINAR Kendigelen, MD | Istanbul University - Cerrahpasa | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul University-Cerrahpasa | Istanbul | 34098 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19654121 | Background | Rudraraju P, Eisen LA. Confirmation of endotracheal tube position: a narrative review. J Intensive Care Med. 2009 Sep-Oct;24(5):283-92. doi: 10.1177/0885066609340501. Epub 2009 Aug 3. |
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Data available on reasonable request
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