小児気管チューブ挿入長決定法の比較 Comparison of Methods for Estimating Optimal Pediatric Endotracheal Tube Depth

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  小児の気管チューブの挿入長は安全域が狭く,その決定に注意が必要である.現時点で利用可能な5つの挿入長決定法の有効性を比較し,不適切となる原因を調査した.適切な気管チューブの先端位置は「胸部X線写真による気管チューブの先端位置が両側鎖骨中線と気管分岐部より0.5cm頭側の間」と定義し,気管挿管後,胸部X線写真により気管チューブ先端の適切範囲を評価し,各種挿入長決定法に基づき算出した挿入長との関係を評価した.各種決定法で適切範囲内に収まる割合は56.0~64.0%,浅過ぎる割合は26.0~42.0%,深過ぎる割合は0.0~14.0%であった.現存する挿入長決定法では適切範囲内に収まる割合は低く,各種挿入長決定法により不適切な位置になる原因も異なっている.今後,より正確な挿入長決定法の構築が必要である.

  In pediatric patients, anesthesiologists need to be extra vigilant about the depth of insertion of the endotracheal tube (ETT), as compared to that in adults. We investigated the usefulness of five major methods that are currently available for estimating optimal pediatric endotracheal tube insertion depth, and investigated the details of inappropriateness. Optimal insertion depth of ETT is defined as the depth at which the tip of the ETT is located below the thoracic inlet and ≥0.5 cm above the carina. We used chest X-rays to measure the range of optimal depth of insertion of orally inserted ETT in each patient, and evaluated whether the values derived from the five methods for depth estimation fit the range. Using these methods, the ETT was inserted to an appropriate depth in 56-64% of children, inappropriately shallow depth in 26-42% of children and inappropriately deep depths in 0.0-14.0% of children, as determined by X-rays. By using the available methods for pediatric ETT depth estimation, the rates of accurate assessment of optimal depth of insertion were low, with the causes of inappropriateness being variable. More accurate methods for estimating optimal pediatric endotracheal tube depth should be devised.

収録刊行物

  • 日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia

    日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia 32(3), 371-374, 2012-05-15

    THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA

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各種コード

  • NII論文ID(NAID)
    10030763239
  • NII書誌ID(NCID)
    AN00330159
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    02854945
  • データ提供元
    CJP書誌  J-STAGE 
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