• Qing-he Zhou, Wang-pin Xiao, and Hong-mei Zhou.
• Department of Anesthesia, Second Affiliated Hospital, School of Medicine, Jiaxing University, Jiaxing, China.
• Paediatr Anaesth. 2015 Nov 1; 25 (11): 1132-8.

BackgroundIt is challenging for anesthetists to determine the optimal tracheal intubation depth in children. We hypothesize that a measure three times the length of the middle finger can be used for predicting tracheal tube depth in children.MethodsEighty-six children (4-14 years of age) were included in this study. After the children were anesthetized, a fiberoptic bronchoscope (FOB) was inserted into the trachea, the lengths from the upper incisor teeth to carina and vocal cords were measured, and a suitably sized cuffed tracheal tube was inserted into the trachea. Age-based and middle finger length-based formulas were used to determine the tracheal intubation depth.ResultsAll 86 children enrolled were included in this study. Compared with the age-based intubation, the rate of appropriate tube placement was higher for middle finger length-based intubation (88.37% vs 66.28%, P = 0.001). The proximal intubation rate was lower in middle finger length-based intubation (4.65% vs 32.56%, P < 0.001). There was only weak evidence for a difference in the distal intubation rate between the two methods (6.97% vs 1.16%, P = 0.054). The correlation coefficient between middle finger length and optimal tracheal tube depth was larger than that between age and optimal tracheal tube depth (0.883 vs 0.845).ConclusionsOur data indicate that the appropriate tube placement rate can be improved by using three times the middle finger length as the tracheal intubation depth in children.© 2015 John Wiley & Sons Ltd.

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