Measurement of the Distances of the Lower Airway in Pediatric Population

Study Overview
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Brief Summary
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Pediatric patients are exposed to increased risk during general anesthesia. A myriad of problems can be encountered in the pediatric population by misplaced endotracheal tubes. Especially, during one-lung ventilation (OLV) a right-sided or left-sided tube is inserted to facilitate the surgery. However, inadvertent tube use, caused by misinterpretation of the distances of the trachea and the main bronchi, may cause unintended hypoxemia, postoperative atelectasis and even mortality. In this study, investigators will measure the distance between distal margin of right lung upper lobe orifice-carina and carina-lip with the help of fiberoptic bronchoscopy (FOB).

Detailed Description
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In ASA-PS I-II-III children between 1-18 years of age who are orotracheally intubated for any reason, the fiber optic bronchoscope will be advanced in the tube and first the carina distance and then the carina to right upper bronchus distance will be measured. Age, weight, height, body mass index (BMI), weight percentile, height percentile, comorbidities, ASA score, tube size, lip margin distance, right upper bronchus to carina distance and right upper lobe to carina distance/ Carina to-lip margin ratio will be recorded.

Official Title
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Measurement of the Distance Between the Orifice of the Right Upper Lobe and Carinae and Labium Oris With Fiberoptic Bronchoscopy in Pediatric Population in Turkey

Conditions
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Airway, Child, Bronchus

Intervention / Treatment
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* Procedure: FOB measurement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients undergoing general anesthesia via an endotracheal tube ASA I-III Exclusion Criteria: Patients that do not meet age criteria Uncontrolled asthma or hyper reactive airway hypoxemia, previous thoracic surgery ASA > III Unstable hemodynamics Patients with tracheal or oral malignancies Patients with face trauma Informed consent not given using a tube with a number too small for the fiberoptic bronchoscope to pass through

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pediatric<br>FOB measurement of the distance between carina and right upper lobe bronchus and carina and labium oris in pediatric population | Procedure: FOB measurement<br>* A FOB will be inserted after anesthesia induction and the distances will be measured by direct observation via the bronchoscope.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Upper/Lower Airway Ratio | Ratio of the distance between labium oris to carina and carina to right upper lobe orifice | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between patient characteristics and distances measured by FOB | Correlation between age, body mass index, gender, percentiles and the distance between labium oris to carina and carina to right upper lobe orifice | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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child, anesthesia, fiberoptic bronchoscopy, lower airway anatomy, right upper lobe bronchus