This study evaluates the effect of head and neck movement in children on endotracheal tube (ETT) tip displacement undergoing head-and-neck surgeries. The tube-tip displacement will be measured using flexible fiberoptic bronchoscope.
In clinical application, especially in head-and-neck surgeries, the operators often change the position of children's head-neck for easy operating. Flexing the head resulted in the ETT moving towards the carina, and extension resulted in the tube being displaced in the opposite direction. Head and neck movement change the length of trachea as well: extending the head resulted in the extension of trachea, while flexing resulted in the opposite. Serious complications following from head and neck movement, such as accidental extubation and endobronchial intubation, threat children's life. In pediatric anesthesia, insertion depth (cm) of orotracheal intubation equals to age/2+12, according to classic intubation formulae. The ETT will be put in the depth calculated by the classic formulae under general anesthesia. The distance of ETT-tip displacement and the length change of trachea will be measured as the head and neck placed as follows: fully extended, neutral position, or fully flexed. These three head and neck positions imitate the head-neck movement during those head-and-neck surgeries.
Study Type
OBSERVATIONAL
Enrollment
172
Department of Anesthesia, Beijing Tsinghua Chang Gung Hospital
Beijing, Beijing Municipality, China
Distance of trachea carina (TC) to endotracheal tube (ETT) tip
Measure the distance between trachea carina to the tip of ETT in three different neck-head positions: fully flexion, neutral positon and fully extension.
Time frame: 10min (time that the measurement need)
Distance of tracheal length
Tracheal length equals the distance between trachea carina (TC) to posterior vocal commissure. Measure Tracheal length in three different neck-head positions: fully flexion, neutral positon and fully extension.
Time frame: 10min (time that the measurement need)
Serious complication of unexpected displacement of the endotracheal tube: accidental extubation
When the operator put the child's neck into extension position, accidental extubation may occur, which can lead to hypoxia and asphyxia.
Time frame: intraoperative
Serious complication of unexpected displacement of the endotracheal tube: endobronchial intubation.
When the operator put the child's neck into flexion position, accidental endobronchial intubation may occur, which can lead to one-lung ventilation and pulmonary edema.
Time frame: intraoperative
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