scholarly journals The accuracy of ultrasound to predict endotracheal tube size for pediatric patients with congenital scoliosis

2020 ◽  
Author(s):  
Jianhong Hao ◽  
Jie Zhang ◽  
Buhuai Dong ◽  
Zhenguo Luo
Keyword(s):  
Endotracheal Tube ◽  
Pediatric Patients ◽  
Cricoid Cartilage ◽  
Congenital Scoliosis ◽  
Transverse Diameter ◽  
Scoliosis Surgery ◽  
Altman Analysis ◽  
Lateral Bending ◽  
Bland Altman Analysis ◽  
Lumbar Scoliosis

Abstract Background: Ultrasonography has been used to predict the necessary endotracheal tube (ETT) size by measuring the cricoid cartilage diameter. The aim of this study was to determine the accuracy of ultrasound to predict ETT size for pediatric patients with congenital scoliosis. Methods: Fifty pediatric patients who underwent scoliosis surgery were included in the study. According to the position of the scoliosis, patients were divided into three groups: Group C (cervical lateral bending), Group T (thoracic scoliosis), and Group L (lumbar scoliosis). For all participants, the transverse diameter of the cricoid cartilage was measured with ultrasonography. The initial ETT size was chosen according to the measurements, then the leak test was used to determine the bestfit ETT size. The ETT size predicted by ultrasound and the bestfit ETT size were compared using Bland-Altman analysis. Results: There was a strong correlation between the bestfit ETT size and the ETT size predicted by ultrasound in Group T (r = 0.93, p < 0.001) and Group L (r = 0.94, p < 0.001) and a moderate correlation in Group C (r = 0.83, p < 0.001). Bland-Altman analysis showed that the ETT size was overestimated by ultrasound in pediatric patients with cervical lateral bending (bias = 0.73 mm, precision = 0.42 mm, limit of agreement = 0.08 to 1.38 mm). Conclusion: Ultrasound is a reliable tool to predict ETT size for pediatric patients with thoracic or lumbar scoliosis. However, pediatric patients with cervical lateral bending will need an ETT smaller than the size predicted by ultrasonography. Trial Registration: Chinese Clinical Trial Registry, TRN: ChiCTR1900023408, date of registration: 05.26.2019, 'retrospectively registered'.

scholarly journals The accuracy of ultrasound to predict endotracheal tube size for pediatric patients with congenital scoliosis

2020 ◽  
Author(s):  
Jianhong Hao ◽  
Jie Zhang ◽  
Buhuai Dong ◽  
Zhenguo Luo
Keyword(s):  
Endotracheal Tube ◽  
Pediatric Patients ◽  
Cricoid Cartilage ◽  
Congenital Scoliosis ◽  
Scoliosis Surgery ◽  
Altman Analysis ◽  
Lateral Bending ◽  
Bland Altman Analysis ◽  
Lumbar Scoliosis ◽  
Best Fit

Abstract Background: Ultrasonography has been used to predict the necessary endotracheal tube (ETT) size by measuring the cricoid cartilage diameter. The aim of this study was to determine the accuracy of ultrasound to predict ETT size for pediatric patients with congenital scoliosis. Methods: Fifty pediatric patients who underwent scoliosis surgery were included in the study. According to the position of the scoliosis, patients were divided into three groups: Group C (cervical lateral bending), Group T (thoracic scoliosis), and Group L (lumbar scoliosis). For all participants, the transverse diameter of the cricoid cartilage was measured with ultrasonography. The initial ETT size was chosen according to the measurements, then the leak test was used to determine the best‑fit ETT size. The ETT size predicted by ultrasound and the best‑fit ETT size were compared using Bland-Altman analysis. Results: There was a strong correlation between the best‑fit ETT size and the ETT size predicted by ultrasound in Group T (r = 0.93, p < 0.001) and Group L (r = 0.94, p < 0.001) and a moderate correlation in Group C (r = 0.83, p < 0.001). Bland-Altman analysis showed that the ETT size was overestimated by ultrasound in pediatric patients with cervical lateral bending (bias = 0.73 mm, precision = 0.42 mm, limit of agreement = 0.08 to 1.38 mm). Conclusion: Ultrasound is a reliable tool to predict ETT size for pediatric patients with thoracic or lumbar scoliosis. However, pediatric patients with cervical lateral bending will need an ETT smaller than the size predicted by ultrasonography. Trial Registration: The trial was registered with the Chinese Clinical Trial Registry (ChiCTR: 1900023408).

scholarly journals The accuracy of ultrasound to predict endotracheal tube size for pediatric patients with congenital scoliosis

2020 ◽  
Author(s):  
Jianhong Hao ◽  
Jie Zhang ◽  
Buhuai Dong ◽  
Zhenguo Luo
Keyword(s):  
Endotracheal Tube ◽  
Pediatric Patients ◽  
Cricoid Cartilage ◽  
Congenital Scoliosis ◽  
Altman Analysis ◽  
Lateral Bending ◽  
Bland Altman Analysis ◽  
Thoracic Scoliosis ◽  
Lumbar Scoliosis ◽  
Best Fit

Abstract Background: Ultrasonography has been used for prediction the endotracheal tube(ETT) size through measuring the cricoid cartilage diameter. The aim of this study was to determine the accuracy of ultrasound to predict ETT size for pediatric patients with congenital scoliosis.Methods:Fifty pediatric patients underwent scoliosis surgery were included in the study. According to the position of scoliosis, patients were divided into three groups: Group C (cervical lateral bending); Group T ( thoracic scoliosis); and Group L (lumbar scoliosis). For all participants, the transverse diameter of the cricoid cartilage was measured with ultrasonography and the initial ETT size was chosen according to the measurements, then the leak test was used to determine the best‑fit ETT size. In each group, the ETT size measured by ultrasound and the best‑fit ETT size were compared using Bland-Altman analysis and linear regression analysis.Results: There was a strong correlation between the best‑fit ETT size and the ETT size predicted by ultrasound in Group T (r=0.93, p<0.001) and Group L(r=0.95, p<0.001) and a moderate correlation in Group C(r=0.83, p<0.001). Bland-Altman analysis show that the ETT size was over estimated by ultrasound in pediatric patients with cervical lateral bending.Conclusion: Ultrasound is a reliable tool to predict ETT size for pediatric patients with thoracic scoliosis and lumbar scoliosis. However, compared to what was predicted by ultrasonography, pediatric patients with cervical lateral bending need a smaller sized ETT.

scholarly journals Measurement of the Endotracheal Tube Diameter Using Computed Tomography Images for Pediatric Patients: Comparison with Classic Formulas

2021 ◽  
Author(s):  
Hatice Dilek Özcanoğlu ◽  
Berna Türkay ◽  
Neşe Kutlutürk Şahin ◽  
Zahide Özlem Ulubay ◽  
Ayşe Sevinç Revanlı ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Endotracheal Tube ◽  
Congenital Heart ◽  
Pediatric Patients ◽  
Transverse Diameter ◽  
External Diameter ◽  
Old Patients ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
The Mean

Objective: In this retrospective study, we aimed to evaluate the compatibility of endotracheal tube (ETT) size used during surgery with tracheal diameter measured by computed tomography(CT) and classic formulas in children who underwent CT imaging preoperatively due to surgical indications. Methods: The study included preoperatively CT scanned, 0-3 year-old patients who were operated due to congenital heart diseases between June 1-October 1, 2018.Using the CT scans, transverse and anteroposterior tracheal diameters were measured from the subglottic level. As these diameters reflect the external diameter of the ETT, the inner diameter-which corresponds the ETT size-was calculated using a correction formula. Besides, Cole’s formula was used to calculate the ETT size for each child, and the tube sizes used during surgeries were obtained from anesthesia charts.ETT sizes were compared. Results: 43 patients (22 girls [51.2%],21 boys [48.8%]) were included.The mean age was 10.5±9.6 months. 18 patients (41.9%) had cyanotic, 25 patients (58.1%) had acyanotic heart disease.Mean corrected transverse and anteroposterior tracheal diameters at CT images were 4.35±0.69mm and 4.30±0.71 mm, respectively. The mean diameter calculated by Cole’s formula was 4.22±0.20 mm. The mean tube size used during surgeries was 4.37±0.60 mm. There was no statistically significant difference between the tube sizes used during the surgeries and the corrected transverse tracheal diameters from CT measurements (p>0.05). But the tube sizes used during the surgeries found significantly larger than the diameters obtained by Cole’s formula (p<0.05). Conclusion: In 0-3 years of age pediatric patients who undergo a congenital heart surgery,corrected tracheal transverse diameter measured by CT is more effective,reliable and less invasive than classic formulas for determining appropriate ETT size

scholarly journals Evaluation of Non-Invasive Measurement of Haemoglobin using PPG in Clinically Ill Pediatric Patients

2019 ◽  
Vol 8 (12) ◽  
pp. 4618-4621
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Linear Regression Analysis ◽  
Venous Blood ◽  
Primary Objective ◽  
Altman Analysis ◽  
Bland Altman Analysis ◽  
Non Invasive ◽  
Characteristic Features ◽  
Invasive Measurement

Non-invasive haemoglobin (SpHb) estimation using Photoplethysmograph signal has gained enormous attention among researches in order to provide an earlydiagnosis to polycythemia, anaemia, various cardiovascular diseases, etc. The primary objective of this work is to evaluate the performance efficiency of SpHb monitoring using PPG in clinically ill pediatric population. PPG signal was obtained from the pediatric patients, and SpHb was calculated from the characteristic features of PPG. Haemoglobin value obtained through venous blood sample was compared with SpHb. Theabsolute mean difference between the SpHb and Hbref was 0.78g/dL (SD 0.99; 0.1 to 4.1).For a statistical analysis of the correlation between SpHb and Hblab, IBM SPSS statistics software was used. Bland-Altman analysis, T-test and Linear regression analysis were further used for finding the agreeability limits. Overestimation of SpHb value was observed for lower Hblab values, and SpHb failed to detect anaemic subject

scholarly journals Estimation of Appropriate Endotracheal Tube Size in Pediatric Patients: Use of Epiphyseal Diameter of the Distal Radius and Subglottic Diameter

2021 ◽  
Author(s):  
Demet Altun ◽  
Can Doruk ◽  
Müşerref Beril Dinçer ◽  
Meltem Merve Güler
Keyword(s):  
Endotracheal Tube ◽  
Distal Radius ◽  
Pediatric Patients ◽  
Outer Diameter ◽  
Transverse Diameter ◽  
Tube Size ◽  
The Us ◽  
Tube Exchange ◽  
Best Fit ◽  
Endotracheal Tube Size

INTRODUCTION: The aim of this study is to test the usefulness of epiphysis of distal radius measurement as a surrogate parameter for endotracheal tube (ETT) size prediction in children. METHODS: Seventy-three children were intubated with cuffed ETT selected according to age-based formula. Transvers diameter of epiphysis of distal radius and subglottic diameter of trachea were measured by ultrasound (US). Correlation between the outer diameter of best-fit endotracheal tube and transvers diameter of both radius epiphysis and subglottic diameter were calculated. The need for tube exchange, time for ultrasound (US) measurements and the ease level of measurements were compared. RESULTS: First attempt success at intubation was 83.6%. The correlation of the epiphysis diameter of the distal radius and best-fit ETT was significant (p<0.001, r= 0.619, r2=0.383, 95% CI=0.419-0.838). Similarly the correlation of subglottic tracheal diameter and best-fit ETT was significant (p<0.001, r=0.744, r2=0.553, 95% CI=0.678-825). Estimated ETT sizes according to radial epiphysis diameter and subglottic diameter were optimal in 82.2% and 94.5% respectively. Time for the US measurements of radial epiphysis and subglottic area were 38.3±9.6 and 24.9±4.6 seconds respectively (p<0.001). The level of ease of US measurements were rated for radial epiphysis as 6 (5-9) and for subglottic area as 8 (7-9) (p<0.001). DISCUSSION AND CONCLUSION: US measured transverse diameter of distal radius epiphysis resulted in similar success rate to age-based formula in our child population. Subglottic diameter measured by US estimates ETT size more accurately; it is also less time consuming and easier.

Reply: Bland-Altman analysis for pupillometer comparison

2010 ◽  
Vol 36 (10) ◽  
pp. 1803-1804
Author(s):  
Magdalena Scheffel ◽  
Christoph Kuehne ◽  
Thomas Kohnen
Keyword(s):  
Altman Analysis ◽  
Bland Altman Analysis

scholarly journals Population-based input function for TSPO quantification and kinetic modeling with [11C]-DPA-713

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Mercy I. Akerele ◽  
Sara A. Zein ◽  
Sneha Pandya ◽  
Anastasia Nikolopoulou ◽  
Susan A. Gauthier ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Kinetic Analysis ◽  
Kinetic Modeling ◽  
Input Function ◽  
Brain Regions ◽  
Population Based ◽  
Patient Specific ◽  
Systematic Bias ◽  
Altman Analysis ◽  
Bland Altman Analysis

Abstract Introduction Quantitative positron emission tomography (PET) studies of neurodegenerative diseases typically require the measurement of arterial input functions (AIF), an invasive and risky procedure. This study aims to assess the reproducibility of [11C]DPA-713 PET kinetic analysis using population-based input function (PBIF). The final goal is to possibly eliminate the need for AIF. Materials and methods Eighteen subjects including six healthy volunteers (HV) and twelve Parkinson disease (PD) subjects from two [11C]-DPA-713 PET studies were included. Each subject underwent 90 min of dynamic PET imaging. Five healthy volunteers underwent a test-retest scan within the same day to assess the repeatability of the kinetic parameters. Kinetic modeling was carried out using the Logan total volume of distribution (VT) model. For each data set, kinetic analysis was performed using a patient-specific AIF (PSAIF, ground-truth standard) and then repeated using the PBIF. PBIF was generated using the leave-one-out method for each subject from the remaining 17 subjects and after normalizing the PSAIFs by 3 techniques: (a) Weightsubject×DoseInjected, (b) area under AIF curve (AUC), and (c) Weightsubject×AUC. The variability in the VT measured with PSAIF, in the test-retest study, was determined for selected brain regions (white matter, cerebellum, thalamus, caudate, putamen, pallidum, brainstem, hippocampus, and amygdala) using the Bland-Altman analysis and for each of the 3 normalization techniques. Similarly, for all subjects, the variabilities due to the use of PBIF were assessed. Results Bland-Altman analysis showed systematic bias between test and retest studies. The corresponding mean bias and 95% limits of agreement (LOA) for the studied brain regions were 30% and ± 70%. Comparing PBIF- and PSAIF-based VT estimate for all subjects and all brain regions, a significant difference between the results generated by the three normalization techniques existed for all brain structures except for the brainstem (P-value = 0.095). The mean % difference and 95% LOA is −10% and ±45% for Weightsubject×DoseInjected; +8% and ±50% for AUC; and +2% and ± 38% for Weightsubject×AUC. In all cases, normalizing by Weightsubject×AUC yielded the smallest % bias and variability (% bias = ±2%; LOA = ±38% for all brain regions). Estimating the reproducibility of PBIF-kinetics to PSAIF based on disease groups (HV/PD) and genotype (MAB/HAB), the average VT values for all regions obtained from PBIF is insignificantly higher than PSAIF (%difference = 4.53%, P-value = 0.73 for HAB; and %difference = 0.73%, P-value = 0.96 for MAB). PBIF also tends to overestimate the difference between PD and HV for HAB (% difference = 32.33% versus 13.28%) and underestimate it in MAB (%difference = 6.84% versus 20.92%). Conclusions PSAIF kinetic results are reproducible with PBIF, with variability in VT within that obtained for the test-retest studies. Therefore, VT assessed using PBIF-based kinetic modeling is clinically feasible and can be an alternative to PSAIF.

scholarly journals Evaluation of automated microvascular flow analysis software AVA 4: a validation study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Christian S. Guay ◽  
Mariam Khebir ◽  
T. Shiva Shahiri ◽  
Ariana Szilagyi ◽  
Erin Elizabeth Cole ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Validation Study ◽  
Validation Studies ◽  
Gold Standard ◽  
Flow Analysis ◽  
Automated Analysis ◽  
Altman Analysis ◽  
Analysis Software ◽  
Bland Altman Analysis ◽  
Microvascular Flow

Abstract Background Real-time automated analysis of videos of the microvasculature is an essential step in the development of research protocols and clinical algorithms that incorporate point-of-care microvascular analysis. In response to the call for validation studies of available automated analysis software by the European Society of Intensive Care Medicine, and building on a previous validation study in sheep, we report the first human validation study of AVA 4. Methods Two retrospective perioperative datasets of human microcirculation videos (P1 and P2) and one prospective healthy volunteer dataset (V1) were used in this validation study. Video quality was assessed using the modified Microcirculation Image Quality Selection (MIQS) score. Videos were initially analyzed with (1) AVA software 3.2 by two experienced investigators using the gold standard semi-automated method, followed by an analysis with (2) AVA automated software 4.1. Microvascular variables measured were perfused vessel density (PVD), total vessel density (TVD), and proportion of perfused vessels (PPV). Bland–Altman analysis and intraclass correlation coefficients (ICC) were used to measure agreement between the two methods. Each method’s ability to discriminate between microcirculatory states before and after induction of general anesthesia was assessed using paired t-tests. Results Fifty-two videos from P1, 128 videos from P2 and 26 videos from V1 met inclusion criteria for analysis. Correlational analysis and Bland–Altman analysis revealed poor agreement and no correlation between AVA 4.1 and AVA 3.2. Following the induction of general anesthesia, TVD and PVD measured using AVA 3.2 increased significantly for P1 (p < 0.05) and P2 (p < 0.05). However, these changes could not be replicated with the data generated by AVA 4.1. Conclusions AVA 4.1 is not a suitable tool for research or clinical purposes at this time. Future validation studies of automated microvascular flow analysis software should aim to measure the new software’s agreement with the gold standard, its ability to discriminate between clinical states and the quality thresholds at which its performance becomes unacceptable.

scholarly journals Comparison of IOP Measurement by Goldmann Applanation Tonometer, ICare Rebound Tonometer, and Tono-Pen in Keratoconus Patients after MyoRing Implantation

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Mahmoud Rateb ◽  
Mahmoud Abdel-Radi ◽  
Zeiad Eldaly ◽  
Mohamed Nagy Elmohamady ◽  
Asaad Noor El Din
Keyword(s):  
Central Corneal Thickness ◽  
Pearson Correlation ◽  
Corneal Thickness ◽  
Altman Analysis ◽  
Bland Altman Analysis ◽  
Rebound Tonometer ◽  
Goldmann Applanation Tonometer ◽  
Significant Difference ◽  
Applanation Tonometer ◽  
Icare Rebound Tonometer

Purpose. To evaluate the different IOP readings by Goldmann applanation tonometer (GAT), ICare rebound tonometer, and Tono-Pen in keratoconus patients after MyoRing implantation. To assess the influence of central corneal thickness (CCT) and thinnest corneal location (TCL) on IOP measurements by different tonometers. Setting. Prospective observational study was conducted in two private centers in Egypt from February 2015 to November 2016. Methods. Seventeen eyes of 10 patients suffering from keratoconus and who underwent MyoRing implantation were recruited. All subjects underwent GAT, ICare, and Tono-Pen IOP measurements in random order. Central corneal thickness and thinnest corneal location were assessed by Pentacam. Difference in mean in IOP readings was assessed by T-test. Correlation between each pair of devices was evaluated by Pearson correlation coefficient. The Bland–Altman analysis was used to assess intertonometer agreement. Results. Seventeen eyes (10 patients) were evaluated. The mean IOP reading was 13.9 ± 3.68, 12.41 ± 2.87, and 14.29 ± 1.31 mmHg in GAT, ICare, and Tono-Pen group, respectively. There was a significant difference between IOP readings by GAT/ICare and Tono-Pen/ICare (p value: 0.032 and 0.002, respectively) with no significant difference between GAT/Tono-Pen (p value: 0.554). Mean difference in IOP measurements between GAT/ICare was 1.49 ± 2.61 mmHg, Tono-Pen/ICare was 1.89 ± 2.15 mmHg, and GAT/Tono-Pen was −0.39 ± 2.59 mmHg. There was no significant correlation between the difference in IOP readings among any pair of devices and CCC or TCL. The Bland–Altman analysis showed a reasonable agreement between any pair of tonometers.

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