Browsing by Author "Artid Samerchua"

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    A Comparison of Pediatric Weight Estimation Methods for Emergency Resuscitation
    (2019-10-01) Artid Samerchua; Suwannee Suraseranivongse; Chulaluk Komoltri; Faculty of Medicine, Siriraj Hospital, Mahidol University; Chiang Mai University
    © Wolters Kluwer Health, Inc. All rights reserved. Objectives Obtaining accurate pediatric weight is necessary during emergency resuscitation. Although several weight estimation methods exist, the most precise method has not been conclusively determined. This study aimed to evaluate the validity, reliability, and practicality of these tools. Methods A prospective observational study was conducted in healthy Thai children aged 6 months to 12 years. Correlations between estimated and actual weights were tested. Validity was assessed by mean bias (estimated weight minus actual weight) and accuracy (10% error). Practicality was evaluated by time usage and data derived from user questionnaires. Results Four hundred thirty participants with mean age of 6.7 years and mean weight of 26 kg were enrolled. A strong correlation between estimated weight and actual weight in all methods was demonstrated. Parental estimation was the most accurate tool in all age groups, with the lowest overall mean error (ME) of -0.83 kg and the highest accuracy of 88.7%. The Broselow tape was the second most accurate tool in ages younger than 1 year and 1-to-5-year age groups (ME = 0.23 and 0.50 kg; accuracy = 55.3% and 54.1%, respectively). The Mercy method was the second most accurate tool in the 6-to-10-year and 11-to-12-year age groups (ME = -2.47 and -2.77; accuracy = 54.6% and 67.9%, respectively). The Broselow tape had the highest score for practicality of use. Conclusions Parental estimation was the most accurate method in every age group. The next best alternative is the Broselow tape in children aged 5 years or younger and the Mercy method in children aged older than 5 years.
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    Predicting uncuffed endotracheal tube size in anesthetized children by ultrasonography: A randomized controlled trial
    (2018-09-01) Kasana Raksamani; Raviwon Atisook; Artid Samerchua; Kattiya Manomayangkul; Naiyana Aroonpruksakul; Faculty of Medicine, Siriraj Hospital, Mahidol University; Chiang Mai University
    © 2018, Medical Association of Thailand. All rights reserved. Objective: The present study aimed to demonstrate that selecting the endotracheal tube [ETT] size using ultrasound measurement of the subglottic diameter is a more reliable method than an age-based formula. Materials and Methods: Ninety-three patients between 1 and 6 years old undergoing elective surgery under general anesthesia with endotracheal intubation were randomized into 2 groups. In group F (n = 46), a modified Cole formula was used to select the ETT size, while in group US (n = 47), ultrasound measurement ofthe subglottic diameter was used to select the ETT size. The appropriate tube size was clinically determined by leakage at airway pressures of 20 to 25 cmH20. Both groups underwent measurement ofthe transverse subglottic diameter in the supine position during apnea and at inspiratory pressures [IP] of 10 cmH20 and 20 cmH20 before intubation to examine the correlation with the outer diameter ofthe appropriate ETT. Results: The incidence of appropriate ETT size selection in group US was 37 out of 47 (78.7%), which was significantly higher than that in group F (n = 24/46, 52.2%), (p = 0.001). A good correlation was found between the ETT size from ultrasound measurement of the transverse subglottic diameter and the outer diameter of the final proper ETT size, with weighted kappa of 0.59±0.06, 0.75±0.06 and 0.70±0.06 at apnea, 10 cmH20 of IP and 20 cmH20 of IP, respectively. No complications were reported in either group during the study. Conclusion: Ultrasound measurement ofthe subglottic diameter to guide the selection of ETT size yielded the appropriate size more frequently than an age-based formula in anesthetized pediatric patients.