Khine et al reported an equation for selecting a cuffed endotracheal tube for a child up to 9 years of age. The authors are from duPont Hospital for Children, Jefferson Medical College and Long Beach Memorial Hospital.
Patient selection: full-term newborn to child 8 years of age (ends at 9th birthday)
Possible cuffed tube sizes: 3.0 mm, 3.5, 4.0, 4.5, 5.0
cuffed tube size with internal diameter in mm =
= ((age in years) / 4) + 3
Age
Cuffed Tube
Uncuffed Tube
full-term newborn to first birthday
3.0 mm
4.0 mm
after first birthday to third birthday
3.5 mm
4.5 mm
after third birthday to fifth birthday
4.0 mm
5.0 mm
after fifth birthday to seventh birthday
4.5 mm
5.5 mm
after seventh birthday to ninth birthday
5.0 mm
6.0 mm
Additional rules:
(1) age is rounded up after a birthday
(2) if there is resistance to passage of the tube into the trachea then a tube 0.5 mm (one size) smaller is placed
(3) if a leak occurs with an inflation pressure < 10 cm water then a tube 0.5 mm (one size) larger is placed
(4) the cuff is inflated using a Shiley pressure relief adapter which limits pressure to 25 mm Hg
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