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ORIGINAL ARTICLE   Free accessfree

Minerva Anestesiologica 2019 December;85(12):1281-8

DOI: 10.23736/S0375-9393.19.13458-X


lingua: Inglese

Automated measurement of tracheal and main bronchial diameters: a feasibility study

Sabrina MA 1, 2, Shérifa ADJAVON 1, 2, Nabil BOUCHIHA 3, 4, Caroline CASTELLI 5, 6, Marc FISCHLER 1, 2 , François MELLOT 7, Morgan LE GUEN 1, 2

1 Department of Anesthesiology, Foch Hospital, Suresnes, France; 2 Versailles Saint-Quentin-en-Yvelines University, Versailles, France; 3 Department of Anesthesiology and Surgical Intensive Care Units, Henri Mondor Hospital, Créteil, France; 4 Créteil Val de Marne University, Créteil, France; 5 Unit of Anesthesiology and Intensive Care, Trauma Center, Nord Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France; 6 Aix Marseille University, Marseille, France; 7 Department of Radiology, Foch Hospital, Suresnes, France

BACKGROUND: A thoracic computed tomography scan is rarely used to help choose the appropriate double-lumen tube. Nowadays, bronchial measurements can be automated using dedicated software. The aim of this prospective monocentric study was to compare manual and automated measurements of the diameter of the trachea and both main bronchi in adult patients free from a history of lung surgery or disease.
METHODS: Diameters of the trachea and of the main stem bronchi were measured by trained physicians or automatically using Thoracic Volume Computer Assisted Reading software (GE Healthcare, Chicago, IL, USA). Manual measurements were considered as the goal standard.
RESULTS: Two hundred and forty-three patients were assessed for eligibility, 216 were allocated to intervention and 173 analyzed: 102 males and 71 females (61.4±13.9 years, 169.7±9.4 cm, 73.3±16.8 kg). Reliability between the two investigators was poor (20.8±9.0% of measurements with a difference >10%). Intraclass correlation coefficient (ICC) and its confidence interval at 95% (ICC [95% CI]) was 0.97 [0.96; 0.98] for the maximal diameter and 0.94 [0.92; 0.95] for the minimal diameter of the trachea (P<0.01 for both). ICC [95% CI] was 0.97 [0.94; 0.98] for the maximal diameter and 0.93 [0.90; 0.95] for the minimal diameter of the right main bronchus (P<0.01 for both). ICC [95% CI] was 0.96 [0.95; 0.97] for the maximal diameter and 0.93 [0.90; 0.95] for the minimal diameter of the left main bronchus (P<0.01 for both).
CONCLUSIONS: This feasibility study has mixed results since automated measurements were not feasible in around 20% of the cases.

KEY WORDS: Bronchi; Intratracheal intubation; X-ray computed tomography

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