Projects

Background: Short and variable length of the trachea precludes accurate placement
of endotracheal tubes (ETTs) in the pediatric population. The incidence of malposition
of the ETT in the pediatric population was reported to be 30–50% warranting
repositioning. The manubriosternal joint (MSJ) and the carina lie in the same
horizontal plane. This can be utilized as a guide during endotracheal intubation in
children. Aims and Objectives: To evaluate the correlation between the incisor-MSJ
(IMSL) length measured in extension and the incisor–carinal length (ICL) and to
predict the airway length in the pediatric population. Materials and Methods: Fifty-
seven children between the ages of 2 and 8 years were recruited for our study.
The length of the IMSL was measured with a tape after inducing anesthesia with
the neck fully extended. Following intubation with appropriately sized ETT, ICL was
measured in neutral position as well as in flexion and extension using fiberscope
and the corresponding measurements were taken. Results: There was a positive
correlation between the two parameters. The mean ICL-N was 15.65±2.17 cm,
and the mean IMSL distance in extension was 16.22±2.46 cm, which was found
to be statistically significant with R2=0.799 (P<0.001). The airway length can
be estimated by the formula: ICL (neutral)=2.828+0.790×IMSL (extension).
Conclusion: The IMSL length can be used as a simple and accurate reference for
predicting the airway length and the depth of insertion of ETTs in the pediatric
population.
Key words: Incisor–carina length; Incisor–manubriosternal joint length; Surface
landmark; Pediatric intubation depth