AUTHOR=Ebenebe Chinedu Ulrich , Schriever Kristina , Wolf Monika , Herrmann Jochen , Singer Dominique , Deindl Philipp 

TITLE=Recommendations for nasotracheal tube insertion depths in neonates

JOURNAL=Frontiers in Pediatrics

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.990423

DOI=10.3389/fped.2022.990423

ISSN=2296-2360

ABSTRACT=<sec><title>Background</title><p>Endotracheal tube (ETT) malposition is common in neonatal intubation. Recommendations for ETT insertion depths predominantly address orotracheal intubation. The aim of this study was to develop gestational age-, weight-, and length-based curve charts and tables for nasotracheal ETT insertion depth recommendations in neonates.</p></sec><sec><title>Method</title><p>In this retrospective single-center study, the individual optimal ETT insertion depths in neonates were determined by evaluating postintubation radiographic images. Gestational age-, weight-, and length-based best-fit curves and tables were generated using regression analysis to calculate related ETT insertion depths. The insertion depths predicted by the models were compared with previously published recommendations.</p></sec><sec><title>Results</title><p>We analyzed intubations of 178 neonates (gestational age range at intubation: 23.7–43.0 weeks). Applying sigmoidal logistic regression models, curves, and tables revealed <italic>R</italic><sup>2</sup> values between 0.766 and 0.837. The insertion depths predicted by the models revealed certain deviations when compared with four previously published recommendations for nasotracheal ETT depth estimation in neonates.</p></sec><sec><title>Conclusion</title><p>The charts and tables developed in this study enable a fast and accurate determination of recommended nasotracheal ETT insertion depths in neonates.</p></sec>