title: The Effect of Transesophageal Echocardiography Probe Placement on Intracuff Pressure of an Endotracheal Tube in Infants and Children.
abstract: OBJECTIVE
  To evaluate the effects of transesophageal echocardiography (TEE) probe insertion on the endotracheal cuff pressure (CP).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Single standing, not-for-profit pediatric hospital.
  
  
  METHODS
  A total of 80 pediatric patients (aged 6 days to 18.4 years) who underwent cardiac surgery and intraoperative TEE.
  
  
  METHODS
  None.
  
  
  RESULTS
  Following anesthesia induction and endotracheal intubation, the CP was recorded at 4 points: before the insertion of the TEE (P1), at TEE insertion (P2), during TEE examination (P3), and after the probe was advanced into the stomach (P4). Twenty patients were enrolled in each of the following age groups:<1 year of age; 1-4 years of age; 5-8 years of age; and 9-18 years of age. CP was compared between pairs of time points using paired t-tests, and differences in CP over time were compared among age groups using repeated-measures analysis of variance. CP at P1, P2, P3, and P4 was 18.7±11.6, 26.7±14.4, 22.3±12.4, and 20.6±12.6 cmH2O, respectively. Although CP significantly increased from P1 to P2 (p<0.001), there was no significant difference between P1 and P4 (95% CI; -0.3 to 4.1; p = 0.083). There was no significant difference in CP change based on the age of the patient.
  
  
  CONCLUSIONS
  Following a transient increase in CP with TEE probe insertion, the CP returned to baseline after the tip of the TEE probe was advanced into the stomach. There was no variation among age groups in the magnitude of the CP change during the study.
authors.affiliation: Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH. Electronic address: Mineto.Kamata@gmail.com.
authors.forename: Mineto
authors.initials: M
authors.lastname: Kamata
authors.affiliation: Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH.
authors.forename: Mumin
authors.initials: M
authors.lastname: Hakim
authors.affiliation: Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Tumin
authors.affiliation: Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH; Department of Anesthesiology & Pain Medicine, The Ohio State University, Columbus, OH.
authors.forename: Senthil G
authors.initials: SG
authors.lastname: Krishna
authors.affiliation: Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH; Department of Anesthesiology & Pain Medicine, The Ohio State University, Columbus, OH.
authors.forename: Aymen
authors.initials: A
authors.lastname: Naguib
authors.affiliation: Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH; Department of Anesthesiology & Pain Medicine, The Ohio State University, Columbus, OH; Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University, Columbus, OH.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D011312:Pressure; D011446:Prospective Studies
keywords: cuffed endotracheal tube; intracuff pressure; pediatric anesthesia; transesophageal echocardiography