• Medicine · Feb 2017

    Retrospective analysis of vocal cord-to-suprasternal notch distance: Implications for preventing endotracheal tube cuff-induced vocal cord injury.

    • Hyerim Kim, Jee-Eun Chang, Jung-Hee Ryu, Haesun Jung, Seong-Won Min, Jung-Man Lee, and Jin-Young Hwang.
    • aDepartment of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro, Dongjak-gu, Seoul bDepartment of Anesthesiology and Pain Medicine, Department of Anesthesiology and Pain Medicin... more e, Seoul National University Bundang Hospital, Bundang-gu, Seong-nam cDepartment of Anesthesiology and Pain Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea. less
    • Medicine (Baltimore). 2017 Feb 1; 96 (7): e6155.

    AbstractEndotracheal tube (ETT) positioning using the cuff ballottement test, which confirms that the inflated cuff is positioned at the suprasternal notch with squeezing or inflating a pilot balloon, has been reported to be a simple and reliable method of preventing endobronchial intubation. However, in patients with a short vocal cord-to-suprasternal notch, ETT placement using the cuff ballottement test can cause vocal cord injury. In the present study, we assessed the distance from a point 15 mm below the vocal cord to the suprasternal notch (VSD-15), the safe position for ETT cuff placement above the suprasternal notch, and investigated variables for predicting VSD-15.We retrospectively examined neck computed tomography in 427 adult patients and measured VSD-15 and the distance from the thyroid notch to the suprasternal notch (TSD). Patient height, weight, sex, and age were also recorded.In total, 47 patients (11.0%) showed a VSD-15 shorter than 45 mm. VSD-15 significantly correlated with TSD (r = 0.778, P < 0.001) and height (r = 0.312, P < 0.001), and inversely correlated with age (r = -0.321, P < 0.001). In multiple linear regression models, a formula was obtained for VSD-15 (VSD-15 [mm] = -6.220 + 0.744 × TSD [mm] + 0.092 × height [cm] - 0.065 × age [years], R = 0.621).The cuff ballottement test should be used cautiously in patients with a predicted short VSD-15. VSD-15 can be predicted from TSD, height, and age.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.