Korean J Anesthesiol.
2021 Aug;74(4):333-341. 10.4097/kja.21114.
Prediction of endotracheal tube size using a printed three-dimensional airway model in pediatric patients with congenital heart disease: a prospective, single-center, single-group study
- Affiliations
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- 1Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Medical Research Institute, Yangsan, Korea
- 2Department of Biomedical Engineering, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Medical Research Institute, Yangsan, Korea
- 3Departmentsof Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Medical Research Institute, Yangsan, Korea
- KMID: 2520727
- DOI: http://doi.org/10.4097/kja.21114
Abstract
- Background
To determine the correct size of endotracheal tubes (ETTs) for endotracheal intubation of pediatric patients, new methods have been investigated. Although the three-dimensional (3D) printing technology has been successful in the field of surgery, there are not many studies in the field of anesthesia. The purpose of this study was to evaluate the accuracy of a 3D airway model for prediction of the correct ETT size, and compare the results with a conventional age-based formula in pediatric patients.
Methods
Thirty-five pediatric patients under six years of age who were scheduled for congenital heart surgery were enrolled. In the pre-anesthetic period, the patient’s computed tomography (CT) images were converted to Standard Triangle Language (STL) files using the 3D conversion program. A Fused Deposition Modelling (FDM) type 3D printer was used to print 3D airway models from the sub-glottis to the upper carina. ETT size was selected by inserting various sized cuffed-ETTs to a printed 3D airway model.
Results
The 3D method selected the correct ETT size in 21 out of 35 pediatric patients (60%), whereas the age-based formula selected the correct ETT size in 9 patients (26%).
Conclusions
Prediction of the correct size of ETTs using a printed 3D airway model demonstrated better results than the age-based formula. This suggests that the selection of ETT size using a printed 3D airway model may be feasible for helping minimize re-intubation attempts and complications in patients with congenital heart disease and/or those with an abnormal range of growth and development.
Keyword
Cited by 2 articles
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Preoperative simulation of endotracheal intubation for selection of proper tube size in pediatric patients
Jong Wook Song
Korean J Anesthesiol. 2021;74(4):283-284. doi: 10.4097/kja.21291.Choice of the correct size of endotracheal tube in pediatric patients
Seyeon Park, Sang-Wook Shin, Hye-Jin Kim, Ji-Uk Yoon, Gyeong-Jo Byeon, Eun-Jung Kim, Hee Young Kim
Anesth Pain Med. 2022;17(4):352-360. doi: 10.17085/apm.22215.
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