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DOI: 10.1055/s-2006-931915
Endotracheal Tube Position in Neonates Requiring Emergency Interhospital Transfer
Publication History
Publication Date:
14 February 2006 (online)
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ABSTRACT
A malpositioned endotracheal tube (ETT) is common following initial intubation. This study assessed ETT position in 53 orotracheally intubated neonates referred for interhospital transfer during a 3-month period. Position of the ETT on first chest radiograph (CXR) after intubation was assessed and related to radiographic lung expansion, with ducumentation that the final ETT length had achieved a satisfactory position. At the time of first CXR, median ETT length at the lips was 7.0 cm (range, 5 to 12 cm) with median tip position at T3.0 (range, C7 to T6). The ETT required repositioning in 58% of patients. Most malpositioned tubes were too low (26 were withdrawn and only four were advanced; p < 0.001), with lung expansion more closely related to vertebral than clavicular position of the ETT. Final ETT length correlated well with corrected gestation (r = 0.83; p < 0.01) and marginally less well with weight (r = 0.79; p < 0.01). From the regression analysis, we provide a table of recommended tube lengths by gestation.
KEYWORDS
Infant - newborn - endotracheal intubation - resuscitation - trachea - Bronchus
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S.T. KempleyM.A. F.R.C.P.C.H.
Royal London Hospital, Whitechapel
London, E1 1BB, United Kingdom