Distances from vocal cords to mid-trachea for optimizing endotracheal tubes depth markers according to gestational age

Paediatric Anaesthesia
Vincent Rigo, Pierre Fayoux

Abstract

Adequate endotracheal tube positioning in preterm infants is complicated by the short length of the airway. Distal markers were designed to help with the insertion of endotracheal tubes at an appropriate depth below the vocal cords. However, those markers are not standardized between manufacturers, each tube size displays only one (sometimes 2) markers to provide information for infants of various gestational ages, and indicated distances are often too long for extremely preterm infants. The study aims to describe vocal cords to mid-tracheal distance for different gestational ages and determine if depth markers should be adjusted accordingly. Half the tracheal length added to the height of the posterior lamina of the cricoids approximates the distance between vocal cords and mid-trachea. Those dimensions were retrospectively retrieved from a database of laryngo-tracheal measurements obtained during autopsies of fetuses and newborn infants free of upper airway malformations. The equation of correlation between gestational age and distance from vocal cords to mid-trachea was used to calculate those distances for different gestational ages. Data were derived from 114 patients. Vocal cords to mid-trachea distance is linearly correl...Continue Reading

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Citations

Mar 17, 2019·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Swapnil Awsar, Karen Brown
Mar 26, 2019·Paediatric Anaesthesia·Nishant KumarAruna Jain
Dec 22, 2020·International Journal of Pediatric Otorhinolaryngology·Allison KeaneJason May

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