Özgün Uygur1, Mehmet Yekta Öncel2, Gülsüm Kadıoğlu Şimşek3, Nilüfer Okur4, Kıymet Çelik4, Özlem Bozkurt5, Ebru Yücesoy5, Demet Terek6, Meltem Koyuncu Arslan1, Yeliz Pekçevik7, Melek Akar1, Özge Altun Köroğlu6, Suna Oğuz3, Nilgün Kültürsay6. 1. Division of Neonatology, Department of Pediatrics, İzmir Tepecik Training and Research Hospital, İzmir, Turkey. 2. Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Izmir Katip Çelebi University, Izmir, Turkey. 3. Clinic of Neonatology, Zekai Tahir Burak Women's Health and Research Hospital, Ankara, Turkey. 4. Clinic of Neonatology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey. 5. Clinic of Neonatology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey. 6. Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey. 7. Department of Radiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
Abstract
OBJECTIVE: Endotracheal intubation is a frequent procedure performed in neonates with respiratory distress. Clinicians use different methods to estimate the intubation insertion depth, but, unfortunately, the improper insertion results are very high. In this study, we aimed to compare the two different methods (Tochen's formula = weight in kilograms + 6 cm; and nasal septum-tragus length [NTL] + 1 cm) used to determine the endotracheal tube (ETT) insertion depth. STUDY DESIGN: Infants who had intubation indications were enrolled in this study. The intubation tube was fixed using the Tochen formula (Tochen group) or the NTL + 1 cm formula (NTL group). After intubation, the chest radiograph was evaluated (above T1, proper place, and below T2). RESULTS: A total of 167 infants (22-42 weeks of gestational age) were included in the study. The proper tube placement rate in both groups was similar (32.4 vs. 30.4% for infants < 34 weeks of gestational age and 56.8 vs. 45.0% in infants > 34 weeks of gestational age). The ETT was frequently placed below T2 at a higher rate in infants with a gestational age of <34 weeks, especially in the NTL group (46% in the Tochen group and 60.7% in the NTL group). CONCLUSION: The NTL + 1 cm formula led to a higher rate of ETT placement below T2, especially in infants with a birth weight of <1,500 g. Therefore, more studies are needed to determine the optimal ETT insertion depth. Thieme. All rights reserved.
OBJECTIVE: Endotracheal intubation is a frequent procedure performed in neonates with respiratory distress. Clinicians use different methods to estimate the intubation insertion depth, but, unfortunately, the improper insertion results are very high. In this study, we aimed to compare the two different methods (Tochen's formula = weight in kilograms + 6 cm; and nasal septum-tragus length [NTL] + 1 cm) used to determine the endotracheal tube (ETT) insertion depth. STUDY DESIGN: Infants who had intubation indications were enrolled in this study. The intubation tube was fixed using the Tochen formula (Tochen group) or the NTL + 1 cm formula (NTL group). After intubation, the chest radiograph was evaluated (above T1, proper place, and below T2). RESULTS: A total of 167 infants (22-42 weeks of gestational age) were included in the study. The proper tube placement rate in both groups was similar (32.4 vs. 30.4% for infants < 34 weeks of gestational age and 56.8 vs. 45.0% in infants > 34 weeks of gestational age). The ETT was frequently placed below T2 at a higher rate in infants with a gestational age of <34 weeks, especially in the NTL group (46% in the Tochen group and 60.7% in the NTL group). CONCLUSION: The NTL + 1 cm formula led to a higher rate of ETT placement below T2, especially in infants with a birth weight of <1,500 g. Therefore, more studies are needed to determine the optimal ETT insertion depth. Thieme. All rights reserved.
Authors: John Madar; Charles C Roehr; Sean Ainsworth; Hege Ersda; Colin Morley; Mario Rüdiger; Christiane Skåre; Tomasz Szczapa; Arjan Te Pas; Daniele Trevisanuto; Berndt Urlesberger; Dominic Wilkinson; Jonathan P Wyllie Journal: Notf Rett Med Date: 2021-06-02 Impact factor: 0.892
Authors: Abdul Razak; Maheer Faden; Jameel Alghamdi; Abdulaziz Binmanee; Abdullah Hawash Alonazi; Anas Hamdoun; Saud Almugaiteeb; Waseemoddin Patel; Hamdi Katar; Fabian Lora; Abdullah Alismail; Adrian Lavery; Ibrahim Hamama; Noura Alsaleem; Manal Alshaikh; Lama Alrasheed; Omar Aldibasi Journal: BMJ Open Date: 2022-01-19 Impact factor: 2.692