The ultrasonography is better than the physically-based formula method in estimating the uncuffed tracheal tube size of Indonesian pediatric patients

Background: The common method for estimating uncuffed tracheal tube (TT) size is using the physically-based formula. However, it's limited by physical differences due to geographical variations. This study aims to compare the accuracy of the uncuffed TT size estimation using the body length formula, the left-hand 5th fingernail width, and the ultrasonographic method in Indonesian pediatric patients. Methods: This study was a comparative observational study on 40 pediatric patients. The estimation of the precise uncuffed TT size done using the body length formula (Group K, n = 14), the left-hand 5th fingernail width method (group L, n = 13), and the ultrasonographic method (group M, n = 13) to measure the subglottic area. The accuracy of the TT size selection was recorded and statistically analyzed using the T-test and Odd Ratio test using SPSS 19.0 software. Result: The highest uncuffed TT size accuracy was found in the ultrasonographic method (92%), while the lowest was found in body length formula (64%). The ultrasonography tends to estimate the precise TT size seven times higher than the body length formula and five times higher than the Left-hand 5th fingernail width. Conclusion: The ultrasonographic method can estimate the precise uncuffed TT size with high accuracy and can be used as the uncuffed TT size estimation method in Indonesian pediatric patients.