Journal of Pediatric Perspectives

Validity of Three Formulas for Measuring Endotracheal Tube Insertion Depth in Children under Mechanical Ventilation

Narges Keshvarparast; Nemat Bilan; Farinaz Amirikar

Volume 11, Issue 3 , March 2023, , Pages 17463-17469

https://doi.org/10.22038/ijp.2023.66353.4989

Abstract

Background: In the process of intubation, inappropriate placement of the endotracheal tube can lead to hypoxemia, aspiration, insufficient ventilation, atelectasis, barotrauma and pneumothorax. ... Read More Background: In the process of intubation, inappropriate placement of the endotracheal tube can lead to hypoxemia, aspiration, insufficient ventilation, atelectasis, barotrauma and pneumothorax. The above complications may be difficult for a patient with severe disease to tolerate; especially when inappropriate placement is not detected by the specialist in the initial evaluation and the diagnosis lasts until the confirmatory chest x-ray is performed. This study evaluated the validity of three formulas in measuring the depth of endotracheal intubation in children under mechanical ventilation.Methods: 60 intubated children aged 2 months to 12 years were included in this study. The patients were randomly divided into three study groups. Endotracheal tube length for each patient was calculated on the basis of the endotracheal tube length formulas (12 + age (years) / 2; endotracheal tube diameter * 3; and 5 + height (cm) / 10). The ideal depth of the endotracheal tube based on chest x-ray was measured as the median distance between the first thoracic vertebra (T1) and the carina in cm. The distance between the ideal depth of the endotracheal tube and the end location of the endotracheal tube was also measured and recorded.Results: The mean age of the patients was 42.90 months and 58.3% of them were boys. The most common indication for intubation was pneumonia, along with respiratory distress (33.3%). Considering the difference in endotracheal tube depth between the two values calculated using the formula and chest X-ray equal to± 0.5 cm, formula 12 + (2 / age) in 55% of patients, formula 3 * endotracheal tube length in 70% patients and formula 5 + (10 / height) in 85% of patients, were correctly estimated endotracheal tube length. On the other hand, it was observed that in 15%, 45% and 40% of the patients, the formula predicted the correct length of the endotracheal tube for correct intubation without any difference while compared to the chest X-ray. In evaluating the results obtained from the formula and length of the endotracheal tube measured by chest X-ray, it was also observed that the formulas 12 + (2 / age), 3 * length of the endotracheal tube and 5 + (10 / height) were significantly correlated with CXR.Conclusion: According to the obtained results, it can be concluded that the formulas used to estimate the depth of endotracheal tube placement in children have low accuracies compared to the gold standard of measurement (chest X-ray). Of course, in comparison to the three formulas (height, weight and diameter of the ETT), the height formula was more accurate than others.

Oxygenation and Ventilation Indices in Relation to the Duration of Mechanical Ventilation in 2-Month to 14-Year-Old Children Admitted to PICU

Zahra Pourramazan; Nemat Bilan; Farinaz Amirikar

Volume 11, Issue 3 , March 2023, , Pages 17487-17494

https://doi.org/10.22038/ijp.2023.66498.4991

Abstract

Background: Respiratory diseases are the most common cause of death in the pediatric population and acute or progressive respiratory failure, which requires mechanical ventilation, ... Read More Background: Respiratory diseases are the most common cause of death in the pediatric population and acute or progressive respiratory failure, which requires mechanical ventilation, is the most common cause of children’s hospitalization in the intensive care unit. Despite advances in recent decades regarding the treatment of acute respiratory diseases in children and innovative settings in mechanical ventilation, there are no clear and comprehensive guidelines for the use of mechanical ventilation in children.Objective: This research aimed to evaluate the correlation between oxygenation and ventilation indices in predicting the duration of mechanical ventilation in children aged two months to 14 years old admitted to PICU.Methods: In this cross-sectional study, 56 patients were included. The required information was extracted from the patients' clinical records and entered into the prepared questionnaires. They included age, sex, and diagnosis, duration of intubation, extubation time, mechanical ventilation parameters, and blood gas parameters. Patients' blood and ventilation data were collected and calculated from the first day of mechanical ventilation until 7 days later to calculate Oxygenation (OI) and Ventilation (VI) indices.Results: Pneumonia, the most common cause of hospitalization in the intensive care unit and the need for intubation, was present in our population (82%) due to aspiration and Covid-19 disease. There was a significant relationship between higher levels of FiO2 and longer duration of patients' intubation (P <0.001). The amount of PIP in each of the first days of intubation was significantly correlated with the duration of the study. A significant direct relationship was found between the ventilation index and oxygenation index. (P <0.05) Except for the sixth day, oxygenation index and duration of intubation were significantly correlated. (P <0.05) This means that along with the increase in oxygenation index, the duration of intubation was also increased. Ventilation index and duration of intubation were also significantly correlated, except on the fourth and fifth days (P <0.05). None of the extubated patients required re-intubation. Eventually, a very weak statistical correlation was found between the intubation period and the final result in the form of discharge and recovery of the patient or his death.Conclusion: Using variables such as gender, PIP and oxygenation, and ventilation indices, in the early days of mechanical ventilation, the prognosis of these patients and better management of their treatment can be judged. It is, finally, emphasized that further studies on larger populations, with more variables and long-term follow-ups are required.

Diagnostic Value of Changes in Serum Calprotectin Level and Patients' Sputum in Response to Treatment of Cystic Fibrosis Exacerbation in Children

Nemat Bilan; Farinaz Amirikar; Sina Raeisi

Volume 9, Issue 5 , May 2021, , Pages 13569-13579

https://doi.org/10.22038/ijp.2020.51898.4130

Abstract

Background Today few studies have focused on using calprotectin as an effective biomarker for monitoring the exacerbation of pulmonary complications in cystic fibrosis (CF). Thus, the ... Read More

Predictive Factors of Influenza Outcome in Pediatric Patients by Pediatric Risk of Mortality (PRISM) III

Nemat Bilan; Farinaz Amirikar; Shamsi Ghaffari

Volume 8, Issue 12 , December 2020, , Pages 12643-12650

https://doi.org/10.22038/ijp.2020.51317.4079

Abstract

Background Influenza viral infections lead to a wide range of respiratory diseases which have an annual pattern and are responsible for significant morbidity and mortality among children. ... Read More

Evaluation of Predictive Factors of Empyema in Children with Parapneumonic Pleural Effusion

Nemat Bilan; Parviz Ahmadi; Shamsi Zaare; Khaled Rahmani

Volume 8, Issue 10 , October 2020, , Pages 12297-12304

https://doi.org/10.22038/ijp.2020.50959.4046

Abstract

Background Empyema is a complication of bacterial pneumonia which has a particular importance due to its significant morbidity and mortality in children. The aim of this study was to ... Read More

Validity of Peripheral Capillary Oxygen Saturation and Normal Mixed Venous Oxygen Tension in Measurement of O2 Content

Nemat Bilan; Elnaz Eskandartash

Volume 7, Issue 9 , September 2019, , Pages 10019-10027

https://doi.org/10.22038/ijp.2019.41833.3522

Abstract

Background The change in venous oxygen saturation occurs earlier, and even its reduction is faster than arterial oxygen saturation. The aim of this study was to validate SvO2 and PvO2 ... Read More

The Role of Rapid Shallow Breathing Index in Predicting Successful Weaning of Pediatric Patients with Respiratory Failure

Azar Dastranji; Nemat Bilan

Volume 7, Issue 2 , February 2019, , Pages 9003-9012

https://doi.org/10.22038/ijp.2018.34592.3045

Abstract

Background About 40 to 60% of all patients admitted to pediatric intensive care unitsundergo mechanical ventilation and 10 to 20% will fail to be extubated. We aimed to determine the ... Read More

Positive Expiratory Pressure (PEP) versus Conventional Chest Physiotherapy in Pediatric Patients with Acute Exacerbation of Cystic Fibrosis

Masoumeh Ghasempour; Nemat Bilan; Mohammadamin Rezazadehsaatlou

Volume 7, Issue 1 , January 2019, , Pages 8881-8888

https://doi.org/10.22038/ijp.2018.34187.3019

Abstract

Background Pulmonary involvement is the main cause of mortality in cystic fibrosis (CF). Airway clearance techniques are non-pharmacological complement options for CF patients. The ... Read More

The Role of Inflammatory Biomarkers in the Management of Children with Asthma

Gholamreza Rahbari Banaeian; Nemat Bilan; Sina Pakdel; Sina Raeisi

Volume 6, Issue 12 , December 2018, , Pages 8727-8735

https://doi.org/10.22038/ijp.2018.33621.2970

Abstract

Background Making decision on asthma as an inflammatory disease is done mostly on the airways function and the patient symptoms which most of them are nonspecific and subjective. Also, ... Read More

The Role of Spirometry in the Diagnosis of Cough Variant Asthma in Children Aged 5 to 15 Years

Masoumeh Ghasempour; Nemat Bilan; Iman vafaei

Volume 5, Issue 12 , December 2017, , Pages 6329-6336

https://doi.org/10.22038/ijp.2017.26518.2276

Abstract

Background Cough variant Asthma (CVA) is defined as chronic cough without wheezing, and may be precursor of typical asthma. Thus, the diagnosis of CVA and early intervention can partly ... Read More

Validity of Spirometry for Diagnosis of Cough Variant Asthma

Iman Vafaei; Nemat Bilan; Masomeh Gasempor

Volume 5, Issue 12 , December 2017, , Pages 6431-6438

https://doi.org/10.22038/ijp.2017.26783.2308

Abstract

Background Cough variant asthma (CVA) is a chronic or recurrent cough without wheezing accompanied by bronchial hyper-responsiveness and eosinophilic inflammation of the airways. ... Read More

The Effect of Education-Modified of Asthma Stimulants on Attitude of the Adolescents with Asthma in Respiratory Specialty Clinics of Tabriz, North West of Iran

Hengameh Khajavikia; Leila Valizadeh; Soheila Zarei; Nemat Bilan; Negar Taleschian-Tabrizi

Volume 5, Issue 2 , February 2017, , Pages 4385-4393

https://doi.org/10.22038/ijp.2016.7657

Abstract

Background: Asthma is the most common chronic disease of childhood and adolescents worldwide that can result in variable restriction in the physical, emotional and social aspects of ... Read More

Validity of Spo2 in Measuring of Oxygenation Index

Nemat Bilan; Farinaz Amirikar; Masomeh Gasempor

Volume 4, Issue 6 , June 2016, , Pages 1935-1941

https://doi.org/10.22038/ijp.2016.6859

Abstract

Background Pulse-oximetry (Spo2) widely uses as a help tools for therapeutic interventions in the pediatric intensive care units (PICU). The aim of this study was to evaluate the validity ... Read More

Effect of Lung Recruitment Maneuver in Children with Acute Lung Injury

Nemat Bilan; Samira Molayi

Volume 4, Issue 5 , May 2016, , Pages 1787-1794

https://doi.org/10.22038/ijp.2016.6714

Abstract

Background Acute lung injury (ALI) is defined as PaO2/FiO2 less than 300 with bilateral pulmonary infiltrates, without pressure is the top of the left atrium. Early diagnosis and treatment ... Read More

Clinical Predictors of Intensive Care Unit Admission for Asthmatic Children

Mohammad Hasan Kargar Maher; Parinaz Habibi; Nemat Bilan

Volume 3, Issue 4.1 , July 2015, , Pages 713-716

https://doi.org/10.22038/ijp.2015.4449

Abstract

IntroductionChildren with severe asthma attack are a challenging group of patients who could be difficult to treat and leading to significant morbidity and mortality. Asthma attack ... Read More

Spontaneous Breathing Trial a Reliable Method for Weaning in Children

Shamsi Gaffari; Masoumeh Ghasempour; Nemat Bilan

Volume 3, Issue 3.2 , June 2015, , Pages 707-712

https://doi.org/10.22038/ijp.2015.4424

Abstract

Introduction Mechanical ventilation may be lifesaving intervention,It can be associated with complications,Thus,successful weaning is constitutive.One of the factors which is ... Read More

Predictive Factors of Respiratory Failure in Children with Guillain-Barre Syndrome

Nemat Bilan; Mohammad Barzegar; Parinaz Habibi

Volume 3, Issue 2.1 , March 2015, , Pages 33-37

https://doi.org/10.22038/ijp.2015.3927

Abstract

Introduction:Guillain-Barre Syndrome(GBS) is the most common cause of acute flaccid paralysis. Respiratory failure is the most serious short-term complication of GBS and invasive mechanical ... Read More

Effects of Reflection on Clinical Learning of Medical Students

Abolgasem Amini; Nemat Bilan; Masumeh Ghasempour

Volume 3, Issue 2.1 , March 2015, , Pages 39-44

https://doi.org/10.22038/ijp.2015.3944

Abstract

Introduction: Reflection is considered as a critical characteristic in professional competitions. Despite propagation of reflection as an important educational issue and existence of ... Read More

Validity of Spo2/Fio2 Ratio in Detection of Acute Lung Injury and Acute Respiratory Distress Syndrome

Nemat Bilan; Azar Dastranji; Afshin Behbahani ghalehgolab

Volume 3, Issue 1.2 , February 2015, , Pages 429-434

https://doi.org/10.22038/ijp.2015.3840

Abstract

Introduction: One ofdiagnostic criteria for Acute Lung Injury and Acute Respiratory Distress Syndrome is pao2/fio2 (PF) ratio 300 for ALI or 200 for ARDS. This criteria ... Read More

Does Re-intubation Increased Risk of Ventilator- Associated Pneumonia (VAP) in Pediatric Intensive Care Unit Patients?

Nemat Bilan; Parinaz Habibi

Volume 3, Issue 1.1 , January 2015, , Pages 411-415

https://doi.org/10.22038/ijp.2015.3774

Abstract

Introduction:ventilator- associated pneumonia(VAP),as defined by the centers for disease control and prevention (CDC),is a pneumonia that occurs in a patient receiving mechanical ventilation ... Read More

Spirometry Findings Following Treatment with Oral and Inhalant Corticosteroids in Mild to Moderate Asthma Exacerbation in Children

Nemat Bilan; Masumeh Ghasempour

Volume 2, Issue 4.3 , December 2014, , Pages 355-361

https://doi.org/10.22038/ijp.2014.3503

Abstract

Introduction: Asthma exacerbation is common in children. Treatment with oral corticosteroids (OCS) and inhaled corticosteroids are suggested for asthma exacerbation. It is shown ... Read More

Factors Affecting the Outcome of Bronchiectasis in Pediatric Patients

Nemat Bilan; Mitra Agakhani; M Niafar

Volume 2, Issue 4.3 , December 2014, , Pages 377-389

https://doi.org/10.22038/ijp.2014.3310

Abstract

Introduction: Bronchiectasis is a common problem in children and early diagnosis can lead to early treatment and prevent of its complications. This study was aimed to evaluate factors ... Read More

Weaning from ventilator and effect of Blender-Humidifier on outcome of it

Nemat Bilan; Shalaleh Ganji

Volume 2, Issue 4.2 , November 2014, , Pages 39-45

https://doi.org/10.22038/ijp.2014.3395

Abstract

Background and objectives: the weaning procedure of mechanical ventilation in many patients is a difficult and long process and increases the time of mechanical ventilation. There are ... Read More

Outcome of Cystic Fibrosis in Patients with Bronchiectasis

Nemat Bilan; Mitra Agakhani; Mahmood Goldost

Volume 2, Issue 4.1 , October 2014, , Pages 313-318

https://doi.org/10.22038/ijp.2014.3299

Abstract

Introduction: Bronchiectasis is a common problem in children especially under 5 years. Early diagnosis of disease and its causes could be useful in early treatment and preventing probable ... Read More

Volume 12 (2024)

Volume 11 (2023)

Volume 10 (2022)

Volume 9 (2021)

Volume 8 (2020)

Volume 7 (2019)

Volume 6 (2018)

Volume 5 (2017)

Volume 4 (2016)

Volume 3 (2015)

Volume 2 (2014)

Volume 1 (2013)

Author = Bilan, Nemat

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