Selection of endotracheal tube size and insertion depth according to pediatric growth charts and physique in Japan

PURPOSE: This study aimed to describe the distribution of clinically selected endotracheal tube size and insertion depth in relation to pediatric growth charts in Japan. METHODS: This single-center retrospective analysis included patients aged 0-15 years who underwent general anesthesia at a university hospital in Japan between December 2006 and July 2023. The correlations between the average endotracheal tube size and depth curves and the growth charts, developed by the Japanese Society for Pediatric Endocrinology and the Japanese Association for Human Auxology, were determined using Pearson's correlation coefficient for the children with heights and weights within ± 2 standard deviations (SD) of the growth chart. For children under 6 years of age in the - 2 to - 3 SD, below - 3 SD, and ± 2 SD groups, a linear mixed model (LMM) was used to model age-related changes in tube size and depth while accounting for clustering by anesthesiologist. RESULTS: A total of 6460 patients were included. In females, uncuffed tube size showed correlations of 0.97 and 0.94 with the height and weight growth charts, respectively; the corresponding correlations for depths were 0.95 and 0.92. In males, the corresponding correlations for size were 0.97 and 0.93, and the corresponding correlations for depth were 0.94 and 0.90. The LMM that accounted for the growth rate of the children showed R-squared values of 0.80 for tube size and 0.76 for insertion depth. CONCLUSION: The curves for the average endotracheal tube size and depth stratified by age showed concordance with the growth chart.