Estimation of Depth of Endotracheal Tube Insertion Using Gestational Age, Body Weight or Nasal-Tragus Length in Newborns: An Open-Label Randomized Controlled Trial.

IF 1.5 4区 医学 Q2 PEDIATRICS
Indian pediatrics Pub Date : 2025-09-01 Epub Date: 2025-07-30 DOI:10.1007/s13312-025-00136-z
Abhishek Yadav, Suksham Jain, Ravinder Kaur, Deepak Chawla, Supreet Khurana, Harshit Kumar, Mahima Rajan, Hemant Gupta, Yaseer Ahmad Mir
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引用次数: 0

Abstract

Objectives: Optimal placement of an endotracheal tube (ETT) tip is necessary for safe and effective ventilation of the lungs. However, there is no consensus on the most accurate method for calculating the depth of ET insertion. To compare the accuracy (proportion of optimally placed ETT) of nasal-tragus length (NTL)-based formula, body weight-based formula, and gestational age (GA)-based method in estimating the depth of oral ETT insertion in neonates.

Methods: Neonates of gestational age 250/7-41+6 weeks undergoing oral endotracheal intubation during the first 28 days of life were randomized into one of three study groups. The depth of ETT insertion was determined using gestational age-based (Kempley), weight-based (Tochen), or NTL-based methods. The optimal position of the ETT tip, assessed by a blinded radiologist on an anteroposterior chest radiograph, was considered to be between the upper border of T1 and the lower border of T2.

Results: In this study, 165 neonates (55 per group) were included. Birth weight, gestational age, proportion of small-for-gestational age neonates, and other baseline characteristics were similar among neonates in the three groups. The rates of optimal ETT placement were not significantly different between the NTL- (47.2%), GA- (45.4%) and weight-based (43.6%) methods (P = 0.911). The corresponding rates of ETT repositioning in the NTL-, GA- and weight-based method groups based on auscultation of chest was 58%, 49% and 29%, respectively (P < 0.001).

Conclusion: No significant difference was observed in the accuracy of the three methods studied. Better methods are needed to calculate the depth of ETT insertion.

Trial registration: Prospectively registered with the Clinical Trial Registry of India (CTRI/2022/12/048221).

用胎龄、体重或新生儿鼻耳屏长度估计气管插管深度:一项开放标签随机对照试验。
目的:气管插管(ETT)尖端的最佳放置是安全有效的肺部通气所必需的。然而,对于计算ET插入深度的最准确方法尚无共识。比较基于鼻耳膜长度(NTL)公式、基于体重公式和基于胎龄(GA)方法估算新生儿口腔ETT插入深度的准确性(最佳放置ETT的比例)。方法:将胎龄250/7-41+6周、出生后28天内经气管插管的新生儿随机分为3个研究组。采用基于胎龄(Kempley)、基于体重(Tochen)或基于ntl的方法确定ETT插入深度。盲法放射科医生在胸部正位x线片上评估ETT尖端的最佳位置,认为是在T1的上边界和T2的下边界之间。结果:本研究共纳入新生儿165例(每组55例)。三组新生儿的出生体重、胎龄、小胎龄新生儿比例和其他基线特征相似。NTL法(47.2%)、GA法(45.4%)和基于体重法(43.6%)的最佳ETT放置率差异无统计学意义(P = 0.911)。基于胸部听诊的NTL、GA和体重法组的ETT重定位率分别为58%、49%和29% (P)。结论:三种方法的准确率无显著差异。需要更好的方法来计算ETT插入深度。试验注册:在印度临床试验注册中心(CTRI/2022/12/048221)前瞻性注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Indian pediatrics
Indian pediatrics 医学-小儿科
CiteScore
3.30
自引率
8.70%
发文量
344
审稿时长
3-8 weeks
期刊介绍: The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are: -To publish original, relevant, well researched peer reviewed articles on issues related to child health. -To provide continuing education to support informed clinical decisions and research. -To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics. -To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.
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