Measurement of subglottic diameter and distance to pre-epiglottic space among Chinese adults
Proper endotracheal tube (ETT) size selection and identification of potentially difficult airways are important to reduce laryngeal injury during intubation. However, controversies exist concerning transverse subglottic diameter-the narrowest part of the airway-and the distance to pre-epiglottic spa...
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| creator | Chan, Wai-Ho Sung, Chih-Wei Chang, Herman Chih-Heng Ko, Patrick Chow-In Huang, Edward Pei-Chuan Lien, Wan-Ching Huang, Chien-Hua Spratley, Jorge |
| description | Proper endotracheal tube (ETT) size selection and identification of potentially difficult airways are important to reduce laryngeal injury during intubation. However, controversies exist concerning transverse subglottic diameter-the narrowest part of the airway-and the distance to pre-epiglottic space. Because few studies have reported the distance from skin to the midpoint of the epiglottis (DSE) among normal individuals, whether the DSE varies between individuals and by ethnicity remains uncertain. The present study aims to investigate the sonographic subglottic diameter and DSE among healthy Chinese adults. Healthy volunteers were recruited at National Taiwan University Hospital between October and November 2019. Exclusion criteria included pre-existing airway or respiratory diseases, neck tumors, and a history of neck operation. Age, sex, height, weight, body mass index (BMI), sonographic DSE, and transverse subglottic diameter were recorded. A total of 124 participants were enrolled. The average age was 32.5 ± 10.4 years and 63 participants (51%) were males. The subglottic diameter was positively associated with sex (males, 14.40 mm; females, 11.10 mm, p < 0.001) and BMI (underweight, 12.13 mm; normal weight, 12.47 mm; overweight, 13.80 mm; obese, 13.67 mm, p = 0.007). Moreover, the DSE was shorter in males (male, 16.18 mm; females, 14.54 mm, p < 0.001) and participants with increased BMI (underweight, 13.70 mm; normal weight, 15.06 mm; overweight, 16.58 mm; obese, 18.18 mm, p < 0.001). As compared with other ethnicity, a smaller size of subglottic diameter and a shorter DSE were noted among Chinese participants, and we suggest that a relatively smaller size of endotracheal tube selection should be considered in tracheal intubations. |
| doi_str_mv | 10.1371/journal.pone.0236364 |
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However, controversies exist concerning transverse subglottic diameter-the narrowest part of the airway-and the distance to pre-epiglottic space. Because few studies have reported the distance from skin to the midpoint of the epiglottis (DSE) among normal individuals, whether the DSE varies between individuals and by ethnicity remains uncertain. The present study aims to investigate the sonographic subglottic diameter and DSE among healthy Chinese adults. Healthy volunteers were recruited at National Taiwan University Hospital between October and November 2019. Exclusion criteria included pre-existing airway or respiratory diseases, neck tumors, and a history of neck operation. Age, sex, height, weight, body mass index (BMI), sonographic DSE, and transverse subglottic diameter were recorded. A total of 124 participants were enrolled. The average age was 32.5 ± 10.4 years and 63 participants (51%) were males. The subglottic diameter was positively associated with sex (males, 14.40 mm; females, 11.10 mm, p < 0.001) and BMI (underweight, 12.13 mm; normal weight, 12.47 mm; overweight, 13.80 mm; obese, 13.67 mm, p = 0.007). Moreover, the DSE was shorter in males (male, 16.18 mm; females, 14.54 mm, p < 0.001) and participants with increased BMI (underweight, 13.70 mm; normal weight, 15.06 mm; overweight, 16.58 mm; obese, 18.18 mm, p < 0.001). As compared with other ethnicity, a smaller size of subglottic diameter and a shorter DSE were noted among Chinese participants, and we suggest that a relatively smaller size of endotracheal tube selection should be considered in tracheal intubations.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0236364</identifier><identifier>PMID: 32706821</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Adults ; Age ; Airway ; Airway management ; Biology and Life Sciences ; Body mass ; Body mass index ; Body size ; Body weight ; Cartilage ; Consent ; Correlation analysis ; Diameters ; Emergency medical care ; Epiglottis ; Ethnicity ; Females ; Injury prevention ; Intubation ; Males ; Medicine ; Medicine and Health Sciences ; Minority & ethnic groups ; Obesity ; Overweight ; Patients ; People and Places ; Physiological aspects ; Research and Analysis Methods ; Respiratory diseases ; Respiratory tract ; Respiratory tract diseases ; Sex ; Software ; Studies ; Trauma ; Tumors ; Ultrasonic imaging ; Underweight ; Ventilators ; Weight</subject><ispartof>PloS one, 2020-07, Vol.15 (7), p.e0236364-e0236364</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Chan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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However, controversies exist concerning transverse subglottic diameter-the narrowest part of the airway-and the distance to pre-epiglottic space. Because few studies have reported the distance from skin to the midpoint of the epiglottis (DSE) among normal individuals, whether the DSE varies between individuals and by ethnicity remains uncertain. The present study aims to investigate the sonographic subglottic diameter and DSE among healthy Chinese adults. Healthy volunteers were recruited at National Taiwan University Hospital between October and November 2019. Exclusion criteria included pre-existing airway or respiratory diseases, neck tumors, and a history of neck operation. Age, sex, height, weight, body mass index (BMI), sonographic DSE, and transverse subglottic diameter were recorded. A total of 124 participants were enrolled. The average age was 32.5 ± 10.4 years and 63 participants (51%) were males. The subglottic diameter was positively associated with sex (males, 14.40 mm; females, 11.10 mm, p < 0.001) and BMI (underweight, 12.13 mm; normal weight, 12.47 mm; overweight, 13.80 mm; obese, 13.67 mm, p = 0.007). Moreover, the DSE was shorter in males (male, 16.18 mm; females, 14.54 mm, p < 0.001) and participants with increased BMI (underweight, 13.70 mm; normal weight, 15.06 mm; overweight, 16.58 mm; obese, 18.18 mm, p < 0.001). As compared with other ethnicity, a smaller size of subglottic diameter and a shorter DSE were noted among Chinese participants, and we suggest that a relatively smaller size of endotracheal tube selection should be considered in tracheal intubations.</description><subject>Adults</subject><subject>Age</subject><subject>Airway</subject><subject>Airway management</subject><subject>Biology and Life Sciences</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Body weight</subject><subject>Cartilage</subject><subject>Consent</subject><subject>Correlation analysis</subject><subject>Diameters</subject><subject>Emergency medical care</subject><subject>Epiglottis</subject><subject>Ethnicity</subject><subject>Females</subject><subject>Injury prevention</subject><subject>Intubation</subject><subject>Males</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Minority & ethnic groups</subject><subject>Obesity</subject><subject>Overweight</subject><subject>Patients</subject><subject>People and Places</subject><subject>Physiological aspects</subject><subject>Research and Analysis Methods</subject><subject>Respiratory diseases</subject><subject>Respiratory tract</subject><subject>Respiratory tract diseases</subject><subject>Sex</subject><subject>Software</subject><subject>Studies</subject><subject>Trauma</subject><subject>Tumors</subject><subject>Ultrasonic 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of subglottic diameter and distance to pre-epiglottic space among Chinese adults</title><author>Chan, Wai-Ho ; Sung, Chih-Wei ; Chang, Herman Chih-Heng ; Ko, Patrick Chow-In ; Huang, Edward Pei-Chuan ; Lien, Wan-Ching ; Huang, Chien-Hua ; Spratley, Jorge</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-ca83d5f98647012eae998128ccfb8d87771fc9f6a23341315e367ff5e6bc99283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adults</topic><topic>Age</topic><topic>Airway</topic><topic>Airway management</topic><topic>Biology and Life Sciences</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Body weight</topic><topic>Cartilage</topic><topic>Consent</topic><topic>Correlation analysis</topic><topic>Diameters</topic><topic>Emergency medical care</topic><topic>Epiglottis</topic><topic>Ethnicity</topic><topic>Females</topic><topic>Injury prevention</topic><topic>Intubation</topic><topic>Males</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Minority & ethnic groups</topic><topic>Obesity</topic><topic>Overweight</topic><topic>Patients</topic><topic>People and Places</topic><topic>Physiological aspects</topic><topic>Research and Analysis Methods</topic><topic>Respiratory diseases</topic><topic>Respiratory tract</topic><topic>Respiratory tract diseases</topic><topic>Sex</topic><topic>Software</topic><topic>Studies</topic><topic>Trauma</topic><topic>Tumors</topic><topic>Ultrasonic imaging</topic><topic>Underweight</topic><topic>Ventilators</topic><topic>Weight</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Wai-Ho</creatorcontrib><creatorcontrib>Sung, Chih-Wei</creatorcontrib><creatorcontrib>Chang, Herman Chih-Heng</creatorcontrib><creatorcontrib>Ko, Patrick Chow-In</creatorcontrib><creatorcontrib>Huang, Edward 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Jorge</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Measurement of subglottic diameter and distance to pre-epiglottic space among Chinese adults</atitle><jtitle>PloS one</jtitle><date>2020-07-24</date><risdate>2020</risdate><volume>15</volume><issue>7</issue><spage>e0236364</spage><epage>e0236364</epage><pages>e0236364-e0236364</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Proper endotracheal tube (ETT) size selection and identification of potentially difficult airways are important to reduce laryngeal injury during intubation. However, controversies exist concerning transverse subglottic diameter-the narrowest part of the airway-and the distance to pre-epiglottic space. Because few studies have reported the distance from skin to the midpoint of the epiglottis (DSE) among normal individuals, whether the DSE varies between individuals and by ethnicity remains uncertain. The present study aims to investigate the sonographic subglottic diameter and DSE among healthy Chinese adults. Healthy volunteers were recruited at National Taiwan University Hospital between October and November 2019. Exclusion criteria included pre-existing airway or respiratory diseases, neck tumors, and a history of neck operation. Age, sex, height, weight, body mass index (BMI), sonographic DSE, and transverse subglottic diameter were recorded. A total of 124 participants were enrolled. The average age was 32.5 ± 10.4 years and 63 participants (51%) were males. The subglottic diameter was positively associated with sex (males, 14.40 mm; females, 11.10 mm, p < 0.001) and BMI (underweight, 12.13 mm; normal weight, 12.47 mm; overweight, 13.80 mm; obese, 13.67 mm, p = 0.007). Moreover, the DSE was shorter in males (male, 16.18 mm; females, 14.54 mm, p < 0.001) and participants with increased BMI (underweight, 13.70 mm; normal weight, 15.06 mm; overweight, 16.58 mm; obese, 18.18 mm, p < 0.001). As compared with other ethnicity, a smaller size of subglottic diameter and a shorter DSE were noted among Chinese participants, and we suggest that a relatively smaller size of endotracheal tube selection should be considered in tracheal intubations.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32706821</pmid><doi>10.1371/journal.pone.0236364</doi><tpages>e0236364</tpages><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adults Age Airway Airway management Biology and Life Sciences Body mass Body mass index Body size Body weight Cartilage Consent Correlation analysis Diameters Emergency medical care Epiglottis Ethnicity Females Injury prevention Intubation Males Medicine Medicine and Health Sciences Minority & ethnic groups Obesity Overweight Patients People and Places Physiological aspects Research and Analysis Methods Respiratory diseases Respiratory tract Respiratory tract diseases Sex Software Studies Trauma Tumors Ultrasonic imaging Underweight Ventilators Weight |
| title | Measurement of subglottic diameter and distance to pre-epiglottic space among Chinese adults |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T08%3A02%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Measurement%20of%20subglottic%20diameter%20and%20distance%20to%20pre-epiglottic%20space%20among%20Chinese%20adults&rft.jtitle=PloS%20one&rft.au=Chan,%20Wai-Ho&rft.date=2020-07-24&rft.volume=15&rft.issue=7&rft.spage=e0236364&rft.epage=e0236364&rft.pages=e0236364-e0236364&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0236364&rft_dat=%3Cgale_plos_%3EA630470166%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2426799020&rft_id=info:pmid/32706821&rft_galeid=A630470166&rft_doaj_id=oai_doaj_org_article_3cf73ed5797f4c76ba93aa6fdd94109f&rfr_iscdi=true |