Clinical trial NCT00687583: Head Movement Effect on Different Tracheal Tubes
Official title: Effect of Head Movement on the Position of Different Tracheal Tubes Determined Radiologically
Study type: OBSERVATIONAL
Overall status: WITHDRAWN
Conditions: Head Movements
Intubation, Intratracheal
Keywords: pediatrics
anesthesia
head movements
endotracheal tube
Lead sponsor: The Hospital for Sick Children
Sponsor class: OTHER
First posted: 2008-06-02
Enrollment: 0
Sex: ALL
Minimum age (years): 1
Maximum age (years): 6
Standard ages: CHILD
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Fifty children undergoing any procedure in the Image Guided Therapy (IGT) department requiring tracheal intubation and chest X-ray, will be recruited and will be evenly distributed in three different age groups (0 to 6 months, 6 to 24 months, 24 months to 6 years).

Brief summary: A breathing tube, which is used to secure the airway and allow ventilation of the lungs during general anaesthesia, is inserted into the windpipe either through the nose or mouth. In children, different formulas exist to determine the appropriate size of the tube according to age, and how far it should be advanced into the airway. Head movement can alter the position of the breathing tube, making it go in or come out too far. Different types of breathing tubes may also differ in their change of position with head movement. The aim of this study is to assess the accuracy of the formulae commonly used in our institution for depth of breathing tube placement, and to measure the degree of tube displacement on head movement with different types of tubes.

Detailed description: An endotracheal tube, which is used to secure the airway and allow ventilation of the lungs during general anesthesia, is inserted into the trachea either through the nose or mouth. In children, different formulae exist to determine the approximate size of the tube according to age, and how far it should be advanced into the airway. Once a tracheal tube is inserted, its position is routinely checked to make sure both lungs are ventilated. To prevent displacement, the tube is taped to the lip, chin or at the nose. However, head movement could cause alteration of the tube position, and risk selective endobronchial intubation or inadvertent extubation. Knowledge of how the different tracheal tubes move with head position can help determine the best tube selection to reduce the risk of accidental tube advancement or removal, in cases where certain head positions are required for surgical access.

The aim of this study is to assess the accuracy of the formulae commonly used in our institution for depth of breathing tube placement, and to measure the degree of tube displacement on head movement with different types of tube. Testing the formulae will enable us to be more aware of how frequently inaccurate tube placement may occur. Knowledge of how the different breathing tubes move with head position can help determine the best tube selection to reduce the risk of the tube going in too far or coming out accidentally, for cases were certain head positions are required for surgery.

Eligibility criteria: Inclusion Criteria:

* Children undergoing any procedure in the Image Guided Therapy (IGT) department requiring tracheal intubation and chest x-ray

Exclusion Criteria:

* Premature neonates
* Patients with cranio-facial anomalies
* Cervical spine/upper thoracic anomalies
* Laryngomalacia/tracheomalacia
* Chronic hypoxemia (i.e. cardiac conditions with right to left shunts)
* Patients requiring positions other than supine

Primary outcomes:
Secondary outcomes:
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: The Hospital for Sick Children
state: Ontario
Study officials:
affiliation: The Hospital for Sick Children, Toronto Canada
name: Cengiz Karsli, MD
role: PRINCIPAL_INVESTIGATOR
References: