Concordance of Age-Based, Height-Based and Weight-Based Tracheal Tube Estimates with Actual Tracheal Tube Size in Children Undergoing Tracheostomy
DOI:
https://doi.org/10.32412/pjohns.v41i2.2863Keywords:
tracheostomy, airway management, child, infant, anthropometry, malnutrition, tracheal tube size, Filipino childrenAbstract
Objective: To determine which among an age-based, height-based and weight-based formula most accurately predicts the actual tracheostomy tube sizes used in Filipino children aged 0–18 years including those with malnutrition (Z scores < –2).
Methods:
Design: Retrospective Review of Records
Setting: Tertiary Government Training Hospital
Participants: Medical Records of 31 patients
Results: Records of 31 patients (15 males [48.39%], 16 females [51.61%]; 15 [48.39%] undernourished) were included. The sample had a median age of 1.5 years (IQR, 10.75), a median weight of 9 kg (IQR, 16), and a median length of 77 cm (IQR, 70.5). Age group and nutritional status significantly influenced estimation accuracy. Both height- based and weight- based formulae significantly overestimated tube size, whereas the age- based formula demonstrated better accuracy, correctly predicting 45.16% of cases, with relatively consistent performance across subgroups but reduced reliability in children aged ≥12 years. When one size above and below the predicted age- based formula value were available, coverage improved to 70.97%.
Conclusion: The Khine age-based formula showed the closest agreement with actual tube sizes and may guide the development of population-specific prediction models for Filipino children. Preparing three tube sizes (estimated, one size larger, and one smaller) may improve procedural safety. Prospective, multicenter studies are recommended to validate these findings and account for variations in growth and nutrition.
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