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A3081
October 14, 2013
8:00:00 AM - 9:00:00 AM
Room Room 104-Area E
Length and Diameter of Mainstem Bronchi in Pediatric Population
Tariq Wani, M.D., Joseph D. Tobias, M.D., Mahmood R. Malik, M.D., Ghulam M. Mir, M.D., Bruno Bissonette, M.D.
Nationwide Childrens Hospital, Columbus, Ohio, United States
Lung isolation in the pediatric population remains difficult despite advances in airway management. The diameter and length dimensions of the right and left mainstem are unknown in young children. Data regarding these measurements will be of help in the development of appropriate lung isolation devices for the pediatric population. Bronchial intubation is sometimes used for selective lung ventilation in pediatric patients. Knowing the dimensions of mainstem bronchi will help guide clinicians in choosing proper size airway equipment for the management of the airway in children. The purpose of the present study was to identify the length and diameter of the left and right mainstem bronchi in young children.

Methods:

After IRB approval, 220 pediatric patients aged 0-8 years undergoing thoracic CT scans were studied. The length and diameter of the left and right main-stem bronchi were studied using the coronal plane CT images. Exclusion criteria included any diagnosis or anatomical condition that would cause abnormal laryngeal anatomy or interfere with measurements. All images were acquired using two CT scan machines (Philips Brilliance 64 and GE Discovery 7050). All children were breathing spontaneously either awake or sedated in the supine position. The head was maintained in the neutral position using head straps as per CT scan protocol. Chloral hydrate was used for sedation.

Results:

The study cohort included 220 patients. The mean age was 47.4 ± 33.1 months with an age range of 1-114 months. There was no difference in the gender distribution. Diameters of the right and left mainstem are reported in Table 1. As expected, the right main bronchus was significantly larger than the left (Table 1). The length of the right mainstem bronchus could not be measured with precision because of its configuration (presence of the upper lobe opening) and therefore is not reported. The mean left mainstem bronchus length is reported in Table 1. Figure 1 shows the CT scan measurements to obtain the diameter and the length of the mainstem bronchus.

/>References:

1- Fayoux P, Marciniak B: Airway development. Pediatric anesthesia : Basic Principles, state of art, future. Bruno Bissonnette. Nov 2011.

Table 1: Main bronchi diameters and length of the left main bronchus

Figure 1: Left mainstem bronchus CT image measurements.
Figure 1
Figure 2

Copyright © 2013 American Society of Anesthesiologists