Yıl: 2018 Cilt: 5 Sayı: 2 Sayfa Aralığı: 71 - 75 Metin Dili: İngilizce DOI: 10.4274/jpr.16870 İndeks Tarihi: 30-07-2019

Assessment of Endotracheal Tube Position After Oral Intubation in Neonates

Öz:
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.
Anahtar Kelime:

Konular: Pediatri
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
1
1
1
  • O’Donnell CP, Kamlin CO, Davis PG, Morley CJ. Endotracheal intubation attempts during neonatal resuscitation: success rates, duration, and adverse effects. Pediatrics 2006;117:16-21.
  • Niermeyer S, Kattwinkel J, Van Reempts P, et al. International Guidelines for Neonatal Resuscitation: An excerpt from the Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science. Contributors and Reviewers for the Neonatal Resuscitation Guidelines. Pediatrics 2000;106:E29.
  • Schmölzer GM, Roehr CC. Techniques to ascertain correct endotracheal tube placement in neonates. Cochrane Libr 2014.
  • Leone TA, Rich W, Finer NN. Neonatal intubation: success of pediatric trainees. J Pediatr 2005;146:638-41.
  • McMillan DD, Rademaker AW, Buchan KA, Reid A, Machin G, Sauve RS. Benefits of orotracheal and nasotracheal intubation in neonates requiring ventilatory assistance. Pediatrics 1986;77:39- 44.
  • Mulcaster JT, Mills J, Hung OR, et al. Laryngoscopic IntubationLearning and Performance. Anesthesiology 2003;98:23-7.
  • Tochen ML. Orotracheal intubation in the newborn infant: a method for determining depth of tube insertion. J Pediatr 1979;95:1050-1.
  • Mainie P, Carmichael A, McCullough S, Kempley S. Endotracheal tube position in neonates requiring emergency interhospital transfer. Am J Perinatol 2006;16:121-4.
  • Wang TC, Kuo LL, Lee CY. Utilizing nasal-tragus length to estimate optimal endotracheal tube depth for neonates in Taiwan. Indian J Pediatr 2011;78:296-300.
  • Çoban A, Kırımi E, Kültürsaray N, et al. 5. Ders: Alternatif Havayolları: Endotrakeal tüp ve Laringeal maske İçinde: Çoban A, (ed). Yenidoğan Canlandırma Programı (NRP) Uygulayıcı Eğitim Kurs Kitabı. Ankara, Turkey, TC Sağlık Bakanlığı, 2017;19- 21.
  • Embleton ND, Deshpande SA, Scott D, Wright C, Milligan DW. Foot length, an accurate predictor of nasotracheal tube length in neonates. Arch Dis Child Fetal Neonatal Ed 2001;85:60-4.
  • Kattwinkel J, Perlman JM, Aziz K, et al. Part 15: neonatal resuscitation 2010 american heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2010;122(18 Suppl 3):909-19.
  • Peterson J, Johnson N, Deakins K, Wilson-Costello D, Jelovsek J, Chatburn R. Accuracy of the 7-8-9 Rule for endotracheal tube placement in the neonate. J Perinatol. 2006;26:333-6.
  • Lee YS, Soong WJ, Jeng MJ, et al. Endotracheal Tube Position in Pediatrics and Neo ates: Comparison Between Flexible Fiberoptic Bronchoscopy and Chest Radiograph. Chi nese Med i cal Jour nal (Tai pei) 2002;65:341-4.
  • Lange M, Jonat S, Nikischin W. Detection and correction of endotracheal-tube position in premature neonates. Pediatr Pulmonol 2002;34:455-61.
  • Çoban A, İnce Z, Kırımi E, et al. Yenidoğan Canlandırma Programı (NRP) Uygulayıcı Eğitim Kurs Kitabı. Ankara, Turkey, TC Sağlık Bakanlığı, 2017.
  • Amarilyo G, Mimouni FB, Oren A, Tsyrkin S, Mandel D. Orotracheal tube insertion in extremely low birth weight infants. J Pediatr 2009;154:764-5.
  • Falck AJ, Escobedo MB, Baillargeon JG, Villard LG, Gunkel JH. Proficiency of pediatric residents in performing neonatal endotracheal intubation. Pediatrics 2003;112:1242-7.
  • Morley CJ, Davis PG, Doyle LW, et al. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med 2008;358:700-8.
  • Kempley ST, Moreiras JW, Petrone FL. Endotracheal tube length for neonatal intubation. Resuscitation 2008;77:369-73.
  • Lubitz DS, Seidel JS, Chameides L, Luten RC, Zaritsky AL, Campbell FW. A rapid method for estimating weight and resuscitation drug dosages from length in the pediatric age group. Ann Emerg Med 1988;17:576-81.
  • Shukla HK, Hendricks-Munoz KD, Atakent Y, Rapaport S. Rapid estimation of insertional length of endotracheal intubation in newborn infants. J Pediatr 1997;131:561-4.
  • Schmolzer GM, Kamlin OC, Dawson JA, te Pas AB, Morley CJ, Davis PG. Respiratory monitoring of neonatal resuscitation. Arch Dis Child Fetal Neonatal Ed 2010;95:295-303.
  • Aziz HF, Martin JB, Moore JJ. The pediatric disposable end-tidal carbon dioxide detector role in endotracheal intubation in newborns. J Perinatol 1999;19:110-3.
APA GÜL A, TAKCI Ş, ANUK İNCE D, ÜNÜVAR Ş (2018). Assessment of Endotracheal Tube Position After Oral Intubation in Neonates. , 71 - 75. 10.4274/jpr.16870
Chicago GÜL ALİ,TAKCI ŞAHİN,ANUK İNCE DENİZ,ÜNÜVAR Şeyma Assessment of Endotracheal Tube Position After Oral Intubation in Neonates. (2018): 71 - 75. 10.4274/jpr.16870
MLA GÜL ALİ,TAKCI ŞAHİN,ANUK İNCE DENİZ,ÜNÜVAR Şeyma Assessment of Endotracheal Tube Position After Oral Intubation in Neonates. , 2018, ss.71 - 75. 10.4274/jpr.16870
AMA GÜL A,TAKCI Ş,ANUK İNCE D,ÜNÜVAR Ş Assessment of Endotracheal Tube Position After Oral Intubation in Neonates. . 2018; 71 - 75. 10.4274/jpr.16870
Vancouver GÜL A,TAKCI Ş,ANUK İNCE D,ÜNÜVAR Ş Assessment of Endotracheal Tube Position After Oral Intubation in Neonates. . 2018; 71 - 75. 10.4274/jpr.16870
IEEE GÜL A,TAKCI Ş,ANUK İNCE D,ÜNÜVAR Ş "Assessment of Endotracheal Tube Position After Oral Intubation in Neonates." , ss.71 - 75, 2018. 10.4274/jpr.16870
ISNAD GÜL, ALİ vd. "Assessment of Endotracheal Tube Position After Oral Intubation in Neonates". (2018), 71-75. https://doi.org/10.4274/jpr.16870
APA GÜL A, TAKCI Ş, ANUK İNCE D, ÜNÜVAR Ş (2018). Assessment of Endotracheal Tube Position After Oral Intubation in Neonates. The Journal of Pediatric Research, 5(2), 71 - 75. 10.4274/jpr.16870
Chicago GÜL ALİ,TAKCI ŞAHİN,ANUK İNCE DENİZ,ÜNÜVAR Şeyma Assessment of Endotracheal Tube Position After Oral Intubation in Neonates. The Journal of Pediatric Research 5, no.2 (2018): 71 - 75. 10.4274/jpr.16870
MLA GÜL ALİ,TAKCI ŞAHİN,ANUK İNCE DENİZ,ÜNÜVAR Şeyma Assessment of Endotracheal Tube Position After Oral Intubation in Neonates. The Journal of Pediatric Research, vol.5, no.2, 2018, ss.71 - 75. 10.4274/jpr.16870
AMA GÜL A,TAKCI Ş,ANUK İNCE D,ÜNÜVAR Ş Assessment of Endotracheal Tube Position After Oral Intubation in Neonates. The Journal of Pediatric Research. 2018; 5(2): 71 - 75. 10.4274/jpr.16870
Vancouver GÜL A,TAKCI Ş,ANUK İNCE D,ÜNÜVAR Ş Assessment of Endotracheal Tube Position After Oral Intubation in Neonates. The Journal of Pediatric Research. 2018; 5(2): 71 - 75. 10.4274/jpr.16870
IEEE GÜL A,TAKCI Ş,ANUK İNCE D,ÜNÜVAR Ş "Assessment of Endotracheal Tube Position After Oral Intubation in Neonates." The Journal of Pediatric Research, 5, ss.71 - 75, 2018. 10.4274/jpr.16870
ISNAD GÜL, ALİ vd. "Assessment of Endotracheal Tube Position After Oral Intubation in Neonates". The Journal of Pediatric Research 5/2 (2018), 71-75. https://doi.org/10.4274/jpr.16870