| Background: There is a controversy over using either smaller- or larger-size
endotracheal tubes (ETT) in children undergoing cardiac surgery, and some
anesthesiologists prefer to use ETT sizes different from the formula-based
sizes. The aim of the present study was to compare proper-size cuffed ETT in
children undergoing cardiac vs noncardiac surgeries.
Methods: In an observational prospective study, 80 children planned to
undergo noncardiac elective surgeries (NCS group) and 80 children scheduled
for cardiac surgeries (CS group) were recruited. For intubation, initial cuffed
ETT size was calculated based on the following formula: Tube size (mm
ID) = age (year)/4 + 3.5. The estimated ETT size for each age group and the
size of final utilized tubes for each age range were recorded.
Results: Patients of tube sizes 4.5, 5, and 5.5 in the CS group were of lower
age, weight, height, and body surface area compared with the patients of the
same tube sizes in the NCS group (P < 0.05). The compatibility of the predicted
vs actual required tube sizes was more in the NCS group compared to
the CS group (72.5% vs 56.2%; P = 0.02). Additionally, the cases with underestimated
tube sizes were significantly more in the CS group compared with
the NCS group (38.8% vs 18.8%, P = 0.01).
Conclusion: Children undergoing cardiac surgeries in relation to their age
and body size do require larger-size ETTs compared with the children scheduled
for noncardiac surgeries |