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By Natalia Kot, MS3
X Oxygenation
X Ventilation
8/(2^4) = 0.5
8/(4^4) = 0.03125
do not protect from aspiration
12 yo girl with cerebral palsy has just come out of the OR after a spinal fusion surgery. She was extubated in the OR, but 6 hours postoperatively, she develops tachycardia and hypotension. O2 sat is 82% on nasal cannula, and CXR shows bilateral pleural effusions.
1. Do we intubate?
2. If so, cuffed or uncuffed tube?
3. Size of ET tube?
4. Depth of ET tube?
She has many risk factors for potential respiratory failure, including the tachycardia, hypotension, and non-reassuring CXR and O2 sat. In addition, she has cerebral palsy, and we know that any neuromuscular disease poses an extra risk of respiratory failure.
Her neuromuscular disorder also places her at increased risk of aspiration → cuffed tube
(Age/4) + 3
= (12/4) + 3
= 3+ 3
= 6 mm
(Age/2) + 12
= (12/2) + 12
= 6 + 12
=18 cm