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Anesth Analg 2006;103:1126-1130
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000240875.40548.23

PEDIATRIC ANESTHESIA

Pediatric Airway and Esophageal Profiles with Acoustic Reflectometry

Gligor Gucev, MD*, David T. Raphael, MD, PhD*, Shlomo Elspas, MD*, and Gary Glass{dagger}

From the *Department of Anesthesiology, Keck School of Medicine, University of Southern California, Los Angeles, California; and {dagger}E. Benson Hood Laboratories, Pembroke, Massachusetts.

Address correspondence to David Raphael, MD, PhD and reprint requests to Gligor Gucev, MD, Department of Anesthesiology, Keck School of Medicine, University of Southern California, 1200 N. State St., Room 14-901, Los Angeles, CA 90033. Address e-mail to draphael{at}usc.edu and gucev{at}usc.edu.

Acoustic reflectometry is a technique by which the dimensions of a cavity can be estimated in the form of an area–distance profile. We conducted a pilot study to obtain the acoustic reflectometry (AR) images associated with breathing tube (endotracheal tube, ETT) placement (inner diameter 4.5–6 mm) and positioning in 21 (n = 21) children, aged 2–12 yr. Characteristic AR profiles, as previously noted in adults, were obtained for tracheal and esophageal intubations in children. Both types of profiles showed constant area throughout the ETT length, followed distally by either a rapid area increase (tracheal) or an area decrease to a near zero value (esophageal). Relative to a tracheal profile, a bronchial intubation exhibits a decrease in area distal to the carina position. With deeper ETT insertion, abutment of the ETT against the bronchial wall can occur, with a possible profound area decrease. The occurrence of ETT abutment in children and neonates, and its possible AR detection and treatment, is discussed.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.