Endotracheal tube management in newborn infants with hyaline membrane disease.

Eighty-six intubated infants with hyaline membrane disease were randomized to have either 0.5 ml saline, or nothing inserted down the endotracheal tube (ETT) prior to 4-hourly suctioning. The aim of the study was to determine if routine saline instillation was of benefit in maintaining ETT patency. The endpoint was (1) when the staff caring for the patient considered the secretions were increasing with the likelihood of the ETT blocking, or (2) the tube was presumed blocked and on removal was blocked. For infants with a 2.5 mm ETT the mean hour of the endpoint was 13.5 if no saline was used and this was increased to 77.6 if saline was used (p<0.05). There was no difference with either a 3.0 or 3.5 mm ETT if saline was used or not.