Utilizing nasal-tragus length to estimate optimal endotracheal tube depth in neonates: A prospective randomized control study.
airway
general anesthesia
neonate
Journal
Paediatric anaesthesia
ISSN: 1460-9592
Titre abrégé: Paediatr Anaesth
Pays: France
ID NLM: 9206575
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
revised:
25
09
2022
received:
28
02
2022
accepted:
03
10
2022
pubmed:
18
10
2022
medline:
5
1
2023
entrez:
17
10
2022
Statut:
ppublish
Résumé
Determination of the optimal depth of endotracheal tube insertion in neonates is challenging. Various formulae have been proposed and are being commonly used for this purpose. There is no single formula that is ideal or can be applied across different populations. To compare weight and nasal-tragus length-based formulae as a guide to endotracheal tube insertion depth in term neonates undergoing surgery. Ther primary objective of the study was to determine the position of the endotracheal tube using either weight-based or nasal-tragus length-based formulae and the secondary objective was to determine the incidence of repositioning of the endotracheal tube. A total of 120 full term neonates were divided into two groups with 60 neonates each (group N = NTL + 1 cm and group W = Weight + 6 cm). Endotracheal tube was inserted according to the pre-calculated value and fixed. A neonatal flexible fiberoptic bronchoscope was used to confirm the position of the endotracheal tube tip by measuring its distance from the carina. Repositioning was done if the distance from carina to endotracheal tube tip was less than 20 mm. Chi-squared and Mann-Whitney tests were used for the analysis. The mean distance measured from carina to endotracheal tube tip in group N was 9.41 ± 6.65 mm and in group W was 3.21 ± 3.45 mm (p value = <.001). A higher incidence of optimal endotracheal tube placement was observed in group N which led to repositioning in 88.3% of neonates in group N and 100% in the group W (53/60 and 60/60, respectively, p value < .05). Based on the results from the studied sample, NTL +1 cm formula is a better predictor than Weight + 6 cm formula to determine endotracheal tube insertion depth in term Indian neonates.
Sections du résumé
BACKGROUND
Determination of the optimal depth of endotracheal tube insertion in neonates is challenging. Various formulae have been proposed and are being commonly used for this purpose. There is no single formula that is ideal or can be applied across different populations.
AIM
To compare weight and nasal-tragus length-based formulae as a guide to endotracheal tube insertion depth in term neonates undergoing surgery. Ther primary objective of the study was to determine the position of the endotracheal tube using either weight-based or nasal-tragus length-based formulae and the secondary objective was to determine the incidence of repositioning of the endotracheal tube.
METHODS
A total of 120 full term neonates were divided into two groups with 60 neonates each (group N = NTL + 1 cm and group W = Weight + 6 cm). Endotracheal tube was inserted according to the pre-calculated value and fixed. A neonatal flexible fiberoptic bronchoscope was used to confirm the position of the endotracheal tube tip by measuring its distance from the carina. Repositioning was done if the distance from carina to endotracheal tube tip was less than 20 mm. Chi-squared and Mann-Whitney tests were used for the analysis.
RESULTS
The mean distance measured from carina to endotracheal tube tip in group N was 9.41 ± 6.65 mm and in group W was 3.21 ± 3.45 mm (p value = <.001). A higher incidence of optimal endotracheal tube placement was observed in group N which led to repositioning in 88.3% of neonates in group N and 100% in the group W (53/60 and 60/60, respectively, p value < .05).
CONCLUSION
Based on the results from the studied sample, NTL +1 cm formula is a better predictor than Weight + 6 cm formula to determine endotracheal tube insertion depth in term Indian neonates.
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
129-133Informations de copyright
© 2022 John Wiley & Sons Ltd.
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