Clinical trial NCT01628978: Verification of Appropriate Insertion Depth of Endotracheal Tube Placement
Official title: Verification of Appropriate Insertion Depth of Endotracheal Tube Placement in Infants and Young Children by Ultrasonography
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Endotracheal Intubation
Infants or Young Children
Keywords: depth of endotracheal tube placement
endotracheal intubation
endobronchial intubation
Lead sponsor: Samsung Medical Center
Sponsor class: OTHER
First posted: 2012-06-27
Enrollment: 60
Sex: ALL
Minimum age (years): 1
Maximum age (years): 10
Standard ages: CHILD
Accepts healthy volunteers: no
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Infants or young children (less than body weight of 20 kg) undergoing elective surgery (general surgery, urology, plastic surgery, otolaryngologic surgery, cardiac surgery) under general anesthesia with endotracheal intubation

Brief summary: 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.

Detailed description: 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.

Eligibility criteria: Inclusion Criteria:

* Infants or young children (less than body weight of 20 kg) undergoing elective surgery (general surgery, urology, plastic surgery, cardiac surgery) under general anesthesia with endotracheal intubation

Exclusion Criteria:

* Patients with pneumothorax, pleural effusion, atelectasis, pneumonia
* hemodynamic unstable patients (inotropics use)
* History of difficult intubation
* Combined upper airway anomaly

Primary outcomes:
measure: the incidence of inadequate depth of endotracheal tube placement by flexible brochoscopy after intubation
timeFrame: 3 minutes after intubation
Secondary outcomes:
measure: incidence of repositioning of endotracheal tube placement
timeFrame: 10 min after anesthetic induction
measure: time to verification of appropriate insertion depth of endotracheal tube placement
timeFrame: 30 minutes after the end of surgery
measure: blood pressure
timeFrame: 5, 10, 20 min after anesthetic induction
measure: heart rate
timeFrame: 5, 10, 20 min after anesthetic induction
measure: pulse oximetry
timeFrame: 5, 10, 20 min after anesthetic induction
Other outcomes:
Locations:
city: Seoul
country: Korea, Republic of
facility: Samsung Medical Center
Study officials:
affiliation: Samsung Medical Center
name: Sangmin M. Lee, MD, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Samsung Medical Center
name: Won Ho Kim, MD
role: PRINCIPAL_INVESTIGATOR
References: