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An ultrasound study of paediatric airways showed sonographic measurement to be a better predictor of tracheal tube size using a formula derived and then validated to estimate external tube diameter than traditional formulae for selecting the internal tube diameter based on age. Since the measurements, taken at the lower edge of the cricoid cartilage, were made after patients were paralyzed, and were performed without ventilation or positive end-expiratory pressure to minimize fluctuation in tracheal diameter, taking about 30 seconds, this is not something I anticipate applying in critical care practice. However, the paper does provide a good opportunity to revise some of the existing formulae. Age in months also correlated with optimal ETT size in mm, although the correlation was weaker than for subglottic diameter:. We, thus, tested the hypothesis that subglottic diameter, as determined by ultrasonography, better predicts optimal ETT size than existing methods. METHODS : A total of patients, aged 1 month to 6 yr, who were scheduled for surgery and undergoing general anesthesia were enrolled and divided into development and validation phases. In the development group, the optimal ETT size was selected according to standard age-based formulas for cuffed and uncuffed tubes.

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