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Research Article: Evaluation and comparison of oral endotracheal tube depth prediction formulas in children with scoliosis: a retrospective study

Date Published: 2026-06-01

Abstract:
Children with scoliosis exhibit unique anatomical characteristics which challenge the accurate prediction of endotracheal tube (ETT) depth. To evaluate commonly used pediatric ETT depth prediction methods in children with scoliosis. This single-center retrospective study included children undergoing posterior thoracolumbar corrective surgery. Univariate and multivariable linear regressions identified independent predictors of intubation depth. Four conventional formulas (Age/2?+?12, ID?×?3, Height/10?+?5, Weight/2?+?8) and x-ray-measured tracheal length were evaluated using Bland-Altman analysis and mean absolute error (MAE). 197 children aged 2–12 years were analyzed. Height correlated most strongly with documented ETT depth (Pearson's r =?0.832, R 2 =?0.692). The Height/10?+?5 formula had the smallest MAE (0.996?cm) and highest safe proportion (72.08%; |predicted–actual|?0.15×tracheal length). Other conventional formulas had larger MAEs (1.713?5.418?cm). Regression-derived formulas improved performance but did not surpass Height/10?+?5. Tracheal length alone had limited predictive power ( R 2 =?0.499). In children with scoliosis, the Height/10?+?5 formula showed the closest agreement with documented ETT depth. Regression-derived formulas require external validation. x-ray-measured tracheal length should be used only adjunctively.

Introduction:
Children with scoliosis exhibit unique anatomical characteristics which challenge the accurate prediction of endotracheal tube (ETT) depth.

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