Jung-Rern Jiang1, Shiao-Yu Yen2, Pei-Fu Chiang3, Hsiao-Chien Liu3. 1. Department of Internal Medicine, St. Joseph's Hospital, #74 Sinsheng Rd, Huwei, 632, Yunlin County, Taiwan. jonzen51@ms14.hinet.net. 2. Department of Health Protection, Public Health Bureau, No. 34 Fuwen Rd, Douliu, 64054, Yunlin County, Taiwan. 3. Department of Respiratory Therapist, St. Joseph's Hospital, #74 Sinsheng Rd, Huwei, 632, Yunlin County, Taiwan.
Abstract
PURPOSE: This study analyzed the clinical factors with the aim to determine the relationship between endotracheal tube (ETT) size and leakage ventilation (LV) and tracheal dilatation. METHODS: All patients with ETT intubation and ventilator support for more than 6 months were retrospectively evaluated. The inner tracheal diameter (TD) was measured over image at the starting and 6 months after ventilator initiated. We compared the clinical factors, outcomes and complications between patients with and without LV, as well as with and without a TD enlarging more than 25% after 6 months (TDn). Logistic regression analyses of factors related to the LV and TDn were performed. The cut-off points of the ratio of outer diameter of ETT (OD) to TD were set and evaluated for their accuracy of predicting LV and TDn. RESULTS: 689 patients were enrolled initially and eventually 199 patients were included, of which 52 and 66 patients were identified to have LV and TDn, respectively. Patients with LV had a higher peak inspiratory pressure (PIP), smaller initial ETT OD/TD and higher incidence of pneumonia. Patients with TDn had a higher PIP, larger initial OD/TD and higher incidence of pneumonia. A higher PIP and smaller initial OD/TD were significantly related to LV and a higher PIP and larger initial OD/TD were significantly related to TDn. The incidence of LV and TDn was higher in patients with an initial OD/TD less than 0.51 and more than 0.54, respectively. CONCLUSION: The initial ETT OD/TD ratio is a predictor for LV and TDn.
PURPOSE: This study analyzed the clinical factors with the aim to determine the relationship between endotracheal tube (ETT) size and leakage ventilation (LV) and tracheal dilatation. METHODS: All patients with ETT intubation and ventilator support for more than 6 months were retrospectively evaluated. The inner tracheal diameter (TD) was measured over image at the starting and 6 months after ventilator initiated. We compared the clinical factors, outcomes and complications between patients with and without LV, as well as with and without a TD enlarging more than 25% after 6 months (TDn). Logistic regression analyses of factors related to the LV and TDn were performed. The cut-off points of the ratio of outer diameter of ETT (OD) to TD were set and evaluated for their accuracy of predicting LV and TDn. RESULTS: 689 patients were enrolled initially and eventually 199 patients were included, of which 52 and 66 patients were identified to have LV and TDn, respectively. Patients with LV had a higher peak inspiratory pressure (PIP), smaller initial ETT OD/TD and higher incidence of pneumonia. Patients with TDn had a higher PIP, larger initial OD/TD and higher incidence of pneumonia. A higher PIP and smaller initial OD/TD were significantly related to LV and a higher PIP and larger initial OD/TD were significantly related to TDn. The incidence of LV and TDn was higher in patients with an initial OD/TD less than 0.51 and more than 0.54, respectively. CONCLUSION: The initial ETT OD/TD ratio is a predictor for LV and TDn.