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Anthropometric Measurements: Effect of CT Depth of Pretracheal Soft Tissue on Tracheotomy Tube Selection

Anthropometric Measurements: Effect of CT Depth of Pretracheal Soft Tissue on Tracheotomy Tube... BACKGROUND AND PURPOSE: Tracheotomy is a commonly performed procedure; however, in the obese, it can be associated with a high morbidity and mortality, partially due to accidental decannulation. We hypothesize that a simple and rapid measurement of the DPST on CT will accurately predict those patients in need of an extended-length tracheotomy tube. MATERIALS AND METHODS: A retrospective review of the electronic health record and available CT imaging of the neck was performed for all patients who underwent tracheotomy at a tertiary care center. Measurement of the DPST was performed and compared with the recorded tracheotomy tube used at surgery. RESULTS: Five hundred twenty-two adult patients underwent an initial tracheotomy procedure, of whom 293 met the inclusion criteria for the study. A statistically significant correlation between the DPST and the need for an extended-length tracheotomy tube was seen. A discriminatory soft-tissue depth indicating the need for an extended-length tracheotomy tube was calculated. CONCLUSIONS: CT measurement of the anterior soft-tissue depth is a simple tool that appears to provide a discriminatory threshold for the need for an extended-length tracheotomy tube. Further validation of this model through prospective application is needed. Although routine use of CT as a pretracheotomy evaluation is not advocated, the anatomic information is often available through prior imaging and has the potential to decrease the incidence of tracheotomy tube dislodgement in the obese and subsequent morbidity. ABBREVIATIONS: BMI body mass index CI confidence interval DPST depth of pretracheal soft tissue ENT ear, nose, and throat OR odds ratio http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Anthropometric Measurements: Effect of CT Depth of Pretracheal Soft Tissue on Tracheotomy Tube Selection

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References (6)

Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2012 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2823
pmid
22173752
Publisher site
See Article on Publisher Site

Abstract

BACKGROUND AND PURPOSE: Tracheotomy is a commonly performed procedure; however, in the obese, it can be associated with a high morbidity and mortality, partially due to accidental decannulation. We hypothesize that a simple and rapid measurement of the DPST on CT will accurately predict those patients in need of an extended-length tracheotomy tube. MATERIALS AND METHODS: A retrospective review of the electronic health record and available CT imaging of the neck was performed for all patients who underwent tracheotomy at a tertiary care center. Measurement of the DPST was performed and compared with the recorded tracheotomy tube used at surgery. RESULTS: Five hundred twenty-two adult patients underwent an initial tracheotomy procedure, of whom 293 met the inclusion criteria for the study. A statistically significant correlation between the DPST and the need for an extended-length tracheotomy tube was seen. A discriminatory soft-tissue depth indicating the need for an extended-length tracheotomy tube was calculated. CONCLUSIONS: CT measurement of the anterior soft-tissue depth is a simple tool that appears to provide a discriminatory threshold for the need for an extended-length tracheotomy tube. Further validation of this model through prospective application is needed. Although routine use of CT as a pretracheotomy evaluation is not advocated, the anatomic information is often available through prior imaging and has the potential to decrease the incidence of tracheotomy tube dislodgement in the obese and subsequent morbidity. ABBREVIATIONS: BMI body mass index CI confidence interval DPST depth of pretracheal soft tissue ENT ear, nose, and throat OR odds ratio

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Mar 1, 2012

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