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 determin...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.展开更多
Introduction Cuffitis is a common phenotype of inflammatory disorder located at the rectal cuff of ileal pouch-anal anastomosis(IPAA)in those with underlying ulcerative colitis(UC)[1,2].Classic cuffitis is considered ...Introduction Cuffitis is a common phenotype of inflammatory disorder located at the rectal cuff of ileal pouch-anal anastomosis(IPAA)in those with underlying ulcerative colitis(UC)[1,2].Classic cuffitis is considered a form of remnant UC following IPAA without mucosectomy.Patients with cuffitis usually respond to topical mesalamine or topical corticosteroid therapy[3,4].Cuffitis can result from other etiologies,such as Crohn’s disease(CD)and prolapse,which often present with asymmetric distribution of the cuff inflammation[1,5].Common symptoms of cuffitis are urgency,frequency,bleeding,and pelvic pressure.Despite advances in the diagnosis and management of ileal pouch disorders,some patients with cuffitis poorly respond to topical and systemic medical therapy.In this brief report,we describe a case in which cuffitis was resolved by the removal of dislodged surgical staples from the anastomosis,suggesting a contributing role of the staples in cuffitis.展开更多
文摘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.
文摘Introduction Cuffitis is a common phenotype of inflammatory disorder located at the rectal cuff of ileal pouch-anal anastomosis(IPAA)in those with underlying ulcerative colitis(UC)[1,2].Classic cuffitis is considered a form of remnant UC following IPAA without mucosectomy.Patients with cuffitis usually respond to topical mesalamine or topical corticosteroid therapy[3,4].Cuffitis can result from other etiologies,such as Crohn’s disease(CD)and prolapse,which often present with asymmetric distribution of the cuff inflammation[1,5].Common symptoms of cuffitis are urgency,frequency,bleeding,and pelvic pressure.Despite advances in the diagnosis and management of ileal pouch disorders,some patients with cuffitis poorly respond to topical and systemic medical therapy.In this brief report,we describe a case in which cuffitis was resolved by the removal of dislodged surgical staples from the anastomosis,suggesting a contributing role of the staples in cuffitis.
