Title
Ultrasound versus traditional formula for subglottic diameter-based uncuffed endotracheal tube selection in pediatric patients
Authors
Urmila Keshari1, Rajni Thakur1, Sherin Soni1,*, R.P. Kaushal1, Lovely Kaushal2 & Ajay Kumar Yadav3
Affiliation
1Department of Anaesthesiology, Gandhi medical College, Bhopal, India; 2Department of Radiology, Gandhi medical College, Bhopal, India; 3Consultant anaesthesiologist, Aster Prime Hospital, Hyderabad, India; *Corresponding author
Urmila Keshari - E-mail: drsurmi@rediffmail.com
Rajni Thakur - E-mail: dr.rajni_1507@rediffmail.com
Sherin Soni - E-mail: sherinsoni9@gmail.com
R.P. Kaushal - E-mail: Rpkaushal1@rediffmail.com
Lovely Kaushal Radiology - E-mail: kaushallovely02@gmail.com
Ajay kumar Yadav - E-mail: ajayky88@gmail.com
Article Type
Research Article
Date
Received April 1, 2026; Revised April 30, 2026; Accepted April 30, 2026, Published April 30, 2026
Abstract
Accurate endotracheal tube (ETT) size selection is vital in pediatric anesthesia, yet traditional age-based formulas such as the modified Cole's formula are often unreliable; ultrasonography (USG), by directly visualizing the subglottic airway, offers a more precise alternative. In a cross-sectional study of 75 children aged 1-8 years, elective cases underwent ultrasound measurement of the mean transverse subglottic diameter, while emergency cases relied on the age-based formula. Ultrasound demonstrated superior accuracy, reducing ETT changes (5% vs. 20%), second intubation attempts (5% vs. 20%) and post-intubation complications (4.5% vs. 16.5%). It also showed higher sensitivity (100% vs. 96%) for predicting appropriate tube size. Thus, we show ultrasonography as a more reliable method than traditional formulas and recommend its integration into routine pediatric airway assessment.
Keywords
Pediatric airway, ultrasonography, endotracheal tube (ETT), subglottic diameter, Cole’s formula
Citation
Keshari et al. Bioinformation 22(4): 2338-2341 (2026)
Edited by
Neelam Goyal & Shruti Dabi
ISSN
0973-2063
Publisher
License
This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.
