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Retrospective analysis of vocal cord-to-suprasternal notch distance: Implications for preventing endotracheal tube cuff-induced vocal cord injury

Endotracheal tube (ETT) positioning using the cuff ballottement test, which confirms that the inflated cuff is positioned at the suprasternal notch with squeezing or inflating a pilot balloon, has been reported to be a simple and reliable method of preventing endobronchial intubation. However, in pa...

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Autores principales: Kim, Hyerim, Chang, Jee-Eun, Ryu, Jung-Hee, Jung, Haesun, Min, Seong-Won, Lee, Jung-Man, Hwang, Jin-Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319539/
https://www.ncbi.nlm.nih.gov/pubmed/28207550
http://dx.doi.org/10.1097/MD.0000000000006155
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author Kim, Hyerim
Chang, Jee-Eun
Ryu, Jung-Hee
Jung, Haesun
Min, Seong-Won
Lee, Jung-Man
Hwang, Jin-Young
author_facet Kim, Hyerim
Chang, Jee-Eun
Ryu, Jung-Hee
Jung, Haesun
Min, Seong-Won
Lee, Jung-Man
Hwang, Jin-Young
author_sort Kim, Hyerim
collection PubMed
description Endotracheal tube (ETT) positioning using the cuff ballottement test, which confirms that the inflated cuff is positioned at the suprasternal notch with squeezing or inflating a pilot balloon, has been reported to be a simple and reliable method of preventing endobronchial intubation. However, in patients with a short vocal cord-to-suprasternal notch, ETT placement using the cuff ballottement test can cause vocal cord injury. In the present study, we assessed the distance from a point 15 mm below the vocal cord to the suprasternal notch (VSD-15), the safe position for ETT cuff placement above the suprasternal notch, and investigated variables for predicting VSD-15. We retrospectively examined neck computed tomography in 427 adult patients and measured VSD-15 and the distance from the thyroid notch to the suprasternal notch (TSD). Patient height, weight, sex, and age were also recorded. In total, 47 patients (11.0%) showed a VSD-15 shorter than 45 mm. VSD-15 significantly correlated with TSD (r = 0.778, P < 0.001) and height (r = 0.312, P < 0.001), and inversely correlated with age (r = −0.321, P < 0.001). In multiple linear regression models, a formula was obtained for VSD-15 (VSD-15 [mm] = −6.220 + 0.744 × TSD [mm] + 0.092 × height [cm] − 0.065 × age [years], R(2) = 0.621). The cuff ballottement test should be used cautiously in patients with a predicted short VSD-15. VSD-15 can be predicted from TSD, height, and age.
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spelling pubmed-53195392017-03-02 Retrospective analysis of vocal cord-to-suprasternal notch distance: Implications for preventing endotracheal tube cuff-induced vocal cord injury Kim, Hyerim Chang, Jee-Eun Ryu, Jung-Hee Jung, Haesun Min, Seong-Won Lee, Jung-Man Hwang, Jin-Young Medicine (Baltimore) 3300 Endotracheal tube (ETT) positioning using the cuff ballottement test, which confirms that the inflated cuff is positioned at the suprasternal notch with squeezing or inflating a pilot balloon, has been reported to be a simple and reliable method of preventing endobronchial intubation. However, in patients with a short vocal cord-to-suprasternal notch, ETT placement using the cuff ballottement test can cause vocal cord injury. In the present study, we assessed the distance from a point 15 mm below the vocal cord to the suprasternal notch (VSD-15), the safe position for ETT cuff placement above the suprasternal notch, and investigated variables for predicting VSD-15. We retrospectively examined neck computed tomography in 427 adult patients and measured VSD-15 and the distance from the thyroid notch to the suprasternal notch (TSD). Patient height, weight, sex, and age were also recorded. In total, 47 patients (11.0%) showed a VSD-15 shorter than 45 mm. VSD-15 significantly correlated with TSD (r = 0.778, P < 0.001) and height (r = 0.312, P < 0.001), and inversely correlated with age (r = −0.321, P < 0.001). In multiple linear regression models, a formula was obtained for VSD-15 (VSD-15 [mm] = −6.220 + 0.744 × TSD [mm] + 0.092 × height [cm] − 0.065 × age [years], R(2) = 0.621). The cuff ballottement test should be used cautiously in patients with a predicted short VSD-15. VSD-15 can be predicted from TSD, height, and age. Wolters Kluwer Health 2017-02-17 /pmc/articles/PMC5319539/ /pubmed/28207550 http://dx.doi.org/10.1097/MD.0000000000006155 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 3300
Kim, Hyerim
Chang, Jee-Eun
Ryu, Jung-Hee
Jung, Haesun
Min, Seong-Won
Lee, Jung-Man
Hwang, Jin-Young
Retrospective analysis of vocal cord-to-suprasternal notch distance: Implications for preventing endotracheal tube cuff-induced vocal cord injury
title Retrospective analysis of vocal cord-to-suprasternal notch distance: Implications for preventing endotracheal tube cuff-induced vocal cord injury
title_full Retrospective analysis of vocal cord-to-suprasternal notch distance: Implications for preventing endotracheal tube cuff-induced vocal cord injury
title_fullStr Retrospective analysis of vocal cord-to-suprasternal notch distance: Implications for preventing endotracheal tube cuff-induced vocal cord injury
title_full_unstemmed Retrospective analysis of vocal cord-to-suprasternal notch distance: Implications for preventing endotracheal tube cuff-induced vocal cord injury
title_short Retrospective analysis of vocal cord-to-suprasternal notch distance: Implications for preventing endotracheal tube cuff-induced vocal cord injury
title_sort retrospective analysis of vocal cord-to-suprasternal notch distance: implications for preventing endotracheal tube cuff-induced vocal cord injury
topic 3300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319539/
https://www.ncbi.nlm.nih.gov/pubmed/28207550
http://dx.doi.org/10.1097/MD.0000000000006155
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