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Orf, J., Thomas, S.H., Ahmed, W., Wiebe, L., Chamberlin, P., Wedel, S.K., et al. (2000) Appropriateness of Endotracheal Tube Size and Insertion Depth in Children Undergoing Air Medical Transport. Pediatric Emergency Care, 16, 321-327.
https://doi.org/10.1097/00006565-200010000-00004

has been cited by the following article:

• TITLE: Novel Formula for Calculation of the Optimal Insertion Depth for Cuffed Endotracheal Tubes in Pediatric Major Surgery

  AUTHORS: Mao Kinoshita, Kazuma Hayase, Mizuki Bando, Naofumi Kawai, Masaru Shimizu, Masayuki Shibasaki

  KEYWORDS: Insertion Depth, Infants, Small Children, Cuffed Endotracheal Tubes

  JOURNAL NAME: Open Journal of Anesthesiology, Vol.9 No.3, March 19, 2019

  ABSTRACT: Background: Accurate determination of the optimal insertion depth of a pediatric endotracheal tube (ETT) is quite important. The aim of this study was to create an easily available formula that can be used to determine the optimal insertion depth for a cuffed ETT even without depth marking with clear definitions of the upper and lower limits for the tip of ETT in the trachea in clinical practice. Methods: Eighty children under 12 years of age were enrolled. The depth marking of the cuffed ETT was placed at the vocal cords and both lungs were then auscultated using a stethoscope. The upper limit was radiographically defined as the position of the tip of the cuffed ETT being between the clavicles. The lower limit was defined as a distance of 5 mm above the carina. The relationship between the insertion depth and patient characteristics was analyzed to create a formula for optimal ETT insertion depth. Results: Sixty-nine ETTs were optimally placed in the trachea. There were good correlations between the optimal insertion depth of ETTs and patients characteristics (height (R = 0.92); BSA (R = 0.92); weight (R = 0.91); age (R = 0.88)). Using these patient characteristics, we created the following three formulas for calculation of the optimal insertion depth for pediatric cuffed ETTs: insertion depth (cm) = height (cm)/11 + 5.5, weight (kg)/3 + 9.5 or 11 + 3/4 × age (years). The rates of appropriate tube placement of both pediatric cuffed ETTs were 87.5% (Hi-Contour) and 85.0% (Microcuff). Conclusions: Our formula and graphs may be easy to determine the optimal insertion depth of cuffed ETT even without depth marking in clinical practice.