Assessment of Endotracheal Tube Position After Oral Intubation in Neonates

Özet

Aim: Endotracheal intubation is a common procedure in the delivery room and neonatal intensive care unit. We aimed to determine the accuracy ofthis method of endotracheal tube (ETT) placement in our neonatal cohort.Materials and Methods: Data on infants requiring oral intubation were reviewed retrospectively. The initial ETT depth of insertion had been calculatedusing the Tochen 7-8-9 rule. The initial depth was compared to the mid-tracheal region. The differences between the initial and ideal depth wascalculated and divided by the mid-tracheal distance. Infants were grouped according to their weights as ≤1000 g, 1001 to 2000 g, 2001 to 3000 g and≥3001 g.Results: We evaluated ETT placement in 160 neonates. The mean gestational age was 32.2±4.4 weeks (23 to 41 weeks) and the mean weight was1989±829 g (560 to 3800 g). The mean range of the difference between the initial depth and ideal depth divided by mid-tracheal distance was0.39±0.04, 0.35±0.04, 0.46±0.05, and 0.23±0.04 in infants weighing ≤1000 g, 1001 to 2000 g, 2001 to 3000 g and ≥3001 g respectively (p=0.025).The differences between the 2001-3000 g group and the 1001-2000, also the 2001-3000 g group and the ≥3001 g group were statistically significant(p<0.05).Conclusion: The 7-8-9 rule should be used to assess ETT length in neonates, especially in those weighing more than 3 kg. As this rule has low accuracyfor extremely low birth weight neonates, its reliability may not be high for neonates weighing less than 3 kg in weight.