{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T07:51:15Z","timestamp":1785829875889,"version":"3.56.0"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T00:00:00Z","timestamp":1633910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Anatomically, the subglottic area and the cricoid ring are the narrowest portions of the larynx. To limit the potential for damage related to mucosal pressure injuries from the presence of an endotracheal tube, the cuff should be placed below the cricoid in children. Previously, no clinical or imaging method has been used in real time to determine the exact location of the endotracheal tube cuff after endotracheal intubation. Point\u2010of\u2010care ultrasound may provide an option as a safe and rapid means of visualizing the endotracheal tube cuff and its relationship to the cricoid ring thereby achieving ideal endotracheal tube cuff positioning\u2014below the cricoid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective, nonrandomized trial, point\u2010of\u2010care ultrasound was used following endotracheal intubation in children to evaluate the position of the endotracheal tube cuff in relationship to the cricoid and tracheal rings. After anesthesia was induced and the trachea was intubated, the endotracheal tube cuff and its position in relation to the cricoid and tracheal rings were identified in the longitudinal plane using point\u2010of\u2010care ultrasound. With the patient's neck in a neutral position, the level of the proximal (cephalad) margin of the saline\u2010filled cuff of the endotracheal tube was identified and recorded in relationship to the cricoid and tracheal rings. The ideal position is defined as the cephalad margin of the endotracheal tube cuff below the level of the cricoid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study cohort included 80 patients, ranging in age from 1 to 78\u00a0months. In all patients, the cuff of the ETT, cricoid, and tracheal rings were identified. The cephalad end of the endotracheal tube cuff was found at the level of the cricoid in 16.3% of patients, at the first tracheal ring in 27.5% of patients, at the second tracheal ring in 23.8% of patients, at the third tracheal ring in 17.5% of patients, and at below the fourth tracheal ring in 15% of patients. Initial endotracheal tube cuff position had no significant association with age, height, weight, endotracheal tube size, and endotracheal tube type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Point\u2010of\u2010care ultrasound provides a rapid and effective means of identifying the position of the endotracheal tube cuff in relationship to the cricoid ring. The technique may have applications in the perioperative arena, emergency departments, and intensive care units.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14303","type":"journal-article","created":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T23:03:25Z","timestamp":1633561405000},"page":"1310-1315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Point\u2010of\u2010care ultrasound to confirm endotracheal tube cuff position in relationship to the cricoid in the pediatric population"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0631-3959","authenticated-orcid":false,"given":"Tariq M.","family":"Wani","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Sidra Medicine Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiju","family":"John","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Sidra Medicine Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saif","family":"Rehman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Sidra Medicine Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"Bhaskar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Sidra Medicine Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aslam F","family":"Sahabudheen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Sidra Medicine Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyad R.","family":"Mahfoud","sequence":"additional","affiliation":[{"name":"Department of Medical Education Weill Cornell Medicine Doha Qatar"},{"name":"Department of Population Health Sciences Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph D.","family":"Tobias","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology &amp; 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