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Paediatr Anaesth. 2013 Oct;23(10):934-9. doi: 10.1111/pan.12147. Epub 2013 Mar 23.

Digital palpation of endotracheal tube tip as a method of confirming endotracheal tube position in neonates: an open-label, three-armed randomized controlled trial.

Author information

1
Neonatal Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Abstract

OBJECTIVE:

To compare the malposition rates of endotracheal tubes (ETTs) when the insertional length (IL) is determined by a weight-based nomogram versus when IL is determined by palpation of the ETT tip.

DESIGN:

Open-label, randomized controlled trial (RCT).

SETTING:

Level III neonatal intensive care unit (NICU).

SUBJECTS:

All newborn babies admitted in NICU requiring intubation.

INTERVENTIONS:

Subjects were randomly allocated to one of three groups, wherein IL was determined by (i) weight-based nomogram alone, (ii) weight-based nomogram combined with suprasternal palpation of ETT tip performed by specially trained neonatology fellows, or (iii) combination of weight-based and suprasternal methods by personnel not specially trained.

PRIMARY OUTCOME:

Rate of malposition of ETT as judged on chest X-ray (CXR).

RESULTS:

Fifty seven babies were randomized into group 1(n = 15), group 2 (n = 20), and group 3 (n = 22). The proportion of correct ETT placement was highest in group 2, being 66.7%, 83.3%, and 66.7% in groups 1 through 3, respectively (P value = 0.58). No complication was attributable to palpation technique.

CONCLUSION:

Suprasternal palpation shows promise as a simple, safe, and teachable method of confirming ETT position in neonates.

KEYWORDS:

endotracheal; infant; intubation; newborn; resuscitation

PMID:
23521151
DOI:
10.1111/pan.12147
[Indexed for MEDLINE]
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