The investigators are trying to evaluate the efficacy of ultrasonographic determination of depth of endotracheal tube placement in infants and young children by using the pleural sliding sign.
It is difficult to determine the adequate depth of endotracheal tube placement in infants and young children. It is usually determined by an equation according to the patient's age (12 + age/2, cm) or auscultation method. The auscultation method is to intentionally place the tip of the endotracheal tube into the right main stem bronchus and then withdraw it until breath sounds are equal. The tube is fixed 1 or 2 cm proximal to the point where breath sounds become equal. However, in small children or infant, as the breadth sound in unilateral lung transmits the contralateral lung field and is often difficult to listen in a noisy operation room, it is often difficult to determine the depth by auscultation method. Pleural sliding sign, or sliding lung sign is a ultrasonographic finding that the visceral pleura moves against the parietal pleura. It is used to identify whether the lung is ventilated by ultrasound. The investigators are trying to use this pleural sliding sign to determine the depth of endotracheal tube, and compare this method with auscultation method.
Study Type
OBSERVATIONAL
Enrollment
60
determination of depth of endotracheal tube placement by auscultation
determination of depth of endotracheal tube placement by ultrasound
Samsung Medical Center
Seoul, South Korea
RECRUITINGthe incidence of inadequate depth of endotracheal tube placement by flexible brochoscopy after intubation
the incidence of inadequate depth of endotracheal tube placement by flexible bronchoscopy 3 minute after intubation
Time frame: 3 minutes after intubation
incidence of repositioning of endotracheal tube placement
incidence of repositioning of endotracheal tube placement (when it is found that the depth of endotracheal tube placement was inadequate determined by saturation fall or airway pressure monitoring)
Time frame: 10 min after anesthetic induction
time to verification of appropriate insertion depth of endotracheal tube placement
time to verification of appropriate insertion depth of endotracheal tube placement by a independent observer
Time frame: 30 minutes after the end of surgery
blood pressure
systolic, diastolic, mean blood pressure before attempt of endotracheal intubation (5 min), during determining the depth of endotracheal tube placement (10 min), after determining the depth of endotracheal tube placement (20 min)
Time frame: 5, 10, 20 min after anesthetic induction
heart rate
heart rate before attempt of endotracheal intubation (5 min), during determining the depth of endotracheal tube placement (10 min), after determining the depth of endotracheal tube placement (20 min)
Time frame: 5, 10, 20 min after anesthetic induction
pulse oximetry
pulse oximetry before attempt of endotracheal intubation (5 min), during determining the depth of endotracheal tube placement (10 min), after determining the depth of endotracheal tube placement (20 min)
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Time frame: 5, 10, 20 min after anesthetic induction