Rapid estimation of insertional length of endotracheal intubation in newborn infants☆,☆☆,★
Section snippets
Methods
The study population included sick newborn infants born at New York University Medical Center, Bellevue Hospital, and Flushing Hospital Medical Center that required intubation. During phase I of the study, 66 infants were intubated by the oral route and 18 infants were intubated by the nasal route. The ET tubes used in the study were calibrated at each centimeter distance (Concord/Portex, Keene, N.H.). The following parameters were measured on each patient: (1) nasal-tragus length, defined as
Results
During phase I of the study, 66 infants required orotracheal intubation: 35 females and 31 males with a gestational age of 31.1 ± 4.7 weeks (mean ± 1 SD), with a range of 23 to 42 weeks. Their BWs were 1610 ± 840 gm (mean ± 1 SD), with a range of 550 to 4500 gm. In the nasotracheal group there were 18 infants (10 females and 8 males) with gestational ages of 32.4 ± 4.1 weeks (mean ± 1 SD) and a range of 28 to 40 weeks. Their weights were 1870 ± 1100 gm (mean ± 1 SD), with a range of 837 to 3900
Discussion and Conclusion
This study demonstrates that NTL and STL can be used swiftly and accurately to calculate ET tube insertional length for neonates using the mnemonics. Both the actual and the modified equations can be used to predict ET insertional lengths. NTL and STL are easily and correctly calculated either by measurement tape or by placing the ET tube directly on the respective body part (NTL or STL). Adding 1 or 2 cm to this measurement gives the respective ET tube insertional length for either orotracheal
Acknowledgements
We sincerely thank Mrugank Shukla of Cardozo High School, Bayside, for his typing and art work.
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Cited by (48)
Comparison of four formulas for nasotracheal tube length estimation in pediatric patients: an observational study
2023, Brazilian Journal of Anesthesiology (English Edition)Citation Excerpt :A nasotracheal tube is also better tolerated. However, the indications of nasotracheal intubation are controversial among medical centers.12–15 In addition, a valid and accepted formula for estimation of NTT length is not available.16–19
Delivery room stabilization and respiratory support
2022, Goldsmith's Assisted Ventilation of the Neonate: An Evidence-Based Approach to Newborn Respiratory Care, Seventh EditionEstimating the endotracheal tube insertion length in newborn infants using weight or gestation: A randomized controlled trial
2020, Journal of Neonatal NursingUltrasound-guided lung sliding sign to confirm optimal depth of tracheal tube insertion in young children
2019, British Journal of AnaesthesiaCitation Excerpt :However, we encountered no instance of accidental extubation. Previous studies have found that the depth of the tracheal tube in paediatric patients involved consideration of one or more of the following factors: weight, height, body surface area, the nasal-tragus length, the sternal-tragus length, foot length, or age.22–24 The most commonly used formulae were age-based for patients older than 1 yr and weight-based for those younger than 1 yr.
The Pediatric Airway
2019, A Practice of Anesthesia for Infants and Children
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From the New York University Medical Center, New York, and New York Flushing Hospital, Queens.
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Reprint requests: H. Shukla, MD, Children’s Medical Center, 42-72, Kissena Boulevard, Flushing, NY 11355.
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9/21/80528