Virtual Pediatric Hospital: ElectricAirway: Upper Airway Problems in Children: Discussion of Correct Sizing of Endotracheal Tubes
ElectricAirway: Upper Airway Problems in Children
Discussion of Correct Sizing of Endotracheal Tubes
Donna M. Santer, M.D., Michael P. D'Alessandro, M.D.
Peer Review Status: Externally Peer Reviewed by Lauren D Holinger, MD, Robert J. Winter, MD and the AMA
Endotracheal tubes for children older than 8 years may have a low-pressure, high-volume cuff to help prevent leaking around the tube. Children younger than 8 years old should never have a cuff on the tube, as the cricoid cartilage itself serves as a functional cuff. Estimations of the correct size for an individual child older than 1 year may be made by using the formula: internal diameter of the tube = (16 + the age in years) divided by 4. Thus, a 2-year-old child would probably need a 4.5-mm internal diameter uncuffed tube. Another way is to use a tube with an outside diameter the size of the child's little finger. Term newborns generally will take a 3.5 mm internal diameter, and a 1-year-old child will take a 4.0-mm internal diameter tube. These are only estimates, and endotracheal tubes 0.5 mm larger and smaller should be available. (Chameides, Leon, ed., Textbook of Pediatric Advanced Life Support , American Heart Association and American Academy of Pediatrics, Dallas, TX, 1988, pp. 28.)
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