Case Presentation
Compared with the female patient’s tracheal cross-sectional area in
T3 vertebra,the endotracheal tube (ETT) cuff undersize
was diagnosed in a 70-yr-old with 50kg body weight and 158cm height
during the patient’s chest CT(X-ray computed tomography). Endotracheal
tube was intubated through the mouth with reinforced endotracheal tubes
CT showed tracheal area in T2 vertebra is 584.2
mm2(Fig1A), T3 vertebra is 646.2
mm2(Fig1B), T4 vertebra is
498.8mm2(Fig1C). Endotracheal intubation for patients.
ID of endotracheal tube:7.0 (Guangzhou Weili Medical Equipment Co.,
Ltd., Guangzhou, China). Cuff diameter: 22mm, cross-sectional area of
cuff:380.13 mm2 . The above results are greater than
cross-sectional area of
cuff:380.13 mm2(Fig2). Cuff pressure was maintained
with the minimum leak technique (MLT) and measured with a cuff pressure
gauge[6], Subsequent cuff manometer measurement
demonstrated a pressure of 100cm H2O.
Yousef aljatlany et al demonstrated the formula for measuring
cross-sectional area in tracheal, cross-sectional area = -171.834+
(0.5850×age)+
(86.8685×sex)+(2.3953×height in
com) (Sex will be denoted by “1” for men and “0” for
women)[7], The final calculated tracheal
cross-sectional area of the patient is 247.5734 mm2.
Height-based nomogram for endotracheal tubes (ETT) size selection
derived from the Coordes et al CT imaging
study[8], The final predicted ETT size of the
patient is 6.5 or 7.0mm. According to the above two selection methods,
theoretically, the cuff of endotracheal intubation can effectively seal
the airway, When the intracuff
pressure is 30 cmH2O. However, the true tracheal
cross-sectional area of the patient is unusual.