Displacement of the endotracheal tube caused by change of head position in pediatric anesthesia: evaluation by fiberoptic bronchoscopy.
Displacement of the endotracheal tube (ETT) caused by flexion and extension of the neck and the placement of a tongue depressor was investigated in 10 small children between the ages of 16 and 19 mo by means of a fiberoptic bronchoscope. The ETT tip moved a mean distance of 0.9 cm toward the carina with flexion and 1.7 cm toward the vocal cords with extension of the neck. After the placement of a tongue depressor, the ETT tip, which had once moved toward the vocal cords with neck extension, was displaced a mean distance of 1.2 cm toward the carina. Our results demonstrate that endobronchial intubation and accidental extubation could occur after significant changes of the head position and careless placement of a tongue depressor in small children.
Sugiyama
K
K
Department of Anesthesia, Kagoshima University Dental Hospital, Japan.
Yokoyama
K
K
D000770:Anesthesia, Endotracheal; D001999:Bronchoscopy; D006257:Head; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D009068:Movement