预测小儿气管插管深度的新公式

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预测小儿气管插管深度的新公式
英国的小儿麻醉学杂志（Pediatric Anesthesia）继前期讨论了“关于气管导管有无套囊选择”（Pediatric Anesthesia 2006 16: 1005–1007）之后（DXY 上也进行了相关讨论：http://www.dxy.cn/bbs/post/view?bid=51&id=7221094&sty=1&tpg=2&age=-1）。在新的一期Pediatric Anesthesia 第12月份的杂志上英国学者发表了他们关于"小儿气管插管深度"研究结果。
标题：预测小儿气管插管深度的新公式
摘要：
研究目的：检测小儿气管插管深度的标准估计方法的准确性，从而确定更加准确适合床边预测气管插管深度的公式。
方法：历时一年余，收集了儿科ICU 要求插管的255例患儿的病例资料。记录了患儿的年龄、体重、气管导管的大小及深度；排除气管切开的患儿。
结果：使用线形回归分析收集的资料得出了在小儿最佳预测气管插管深度公式为：
1、大于1岁：经口插管深度（cm）=1/2年龄+13 ； 经鼻插管深度（cm）=1/2年龄+15 。
2、小于1岁：经口（鼻）插管深度（cm）=1/2体重 + 8 （9）
结论：当前的小儿高级复苏指南推荐的预测气管插管公式比实际偏浅；同样在小于1岁的患儿，我们得出的新公式比以前的标准参考更准确。因此我们建议新公式应该前瞻性地进行研究评估其有效性。
Pediatric Anesthesia 2006 16: 1238–1243.
Title : New formulae for predicting tracheal tube length
Background: The aim of this study was to determine the accuracy of standard techniques for estimating oral and nasal tracheal tube length in children and to devise more accurate predictive formulae that can be used at the bedside.
Methods: Data were collected from 255 children who required tracheal intubation whilst on the Pediatric Intensive Care Unit over a period of 1 year. Age, weight, the final length of the tracheal tube and the internal diameter were documented. Patients with a tracheostomy were excluded from the study.
Results: Using linear regression the following formulae best predicted final tracheal tube length.
For children over 1 year of age:
Insertion depth (cm) for orotracheal intubation =1/2 age + 13
Insertion depth (cm) for nasotracheal intubation=1/2 age +15
For children below 1 year of age:
Insertion depth of orotracheal tube (cm) =1/2 weight + 8
Insertion depth of nasotracheal tube (cm) =1/2 weight +9
Conclusions: Current Advanced Paediatric Life Support guidelines underestimate the appropriate tracheal tube lengths for orotracheal intubation in children over 1 year of age. Similarly, the novel weightbased formulae for tracheal tube lengths in children below the age of 1 year proved more accurate than standard reference charts. We therefore recommend that these new formulae are prospectively evaluated.

扉画如斯

个人认为对于新生儿而言，1/2体重+8有点偏深了。

icanseeu

对于新生儿而言，我记得是体重+6