Nasal-tragus length for estimating optimal insertion depth of endotracheal tube in Thai neonates

J Perinatol. 2020 Apr;40(4):595-599. doi: 10.1038/s41372-019-0502-y. Epub 2019 Sep 26.

Abstract

Objective: To develop a nasal-tragus length (NTL)-based table for estimating the endotracheal tube (ETT) insertion depth.

Study design: A prospective study of 110 Thai neonates was conducted in a NICU in Bangkok, Thailand. The correlation between the optimal insertion depth (Opt-Depth) and NTL was determined, and then an NTL-based table for estimating ETT depth was developed. The accuracy of using various methods in estimating ETT depth was compared.

Results: A strong correlation between Opt-Depth and NTL was found (r = 0.897, p < 0.001). There was no significant difference between ETT depth estimated by the NTL-based table and Opt-Depth [mean difference (95% CI) -0.75 (-12.11 to 10.61) mm, p = 0.22]. The accuracies of using NTL + 1, NTL-based, GA-based, and BW-based tables for estimating ETT depth were 32.7%, 55.5%, 61.8%, and 52.7%, respectively.

Conclusion: Our NTL-based table for estimating the ETT depth had an acceptable accuracy while using "NTL + 1" resulted in overestimating ETT depth.

MeSH terms

  • Dimensional Measurement Accuracy
  • Ear, External*
  • Face / anatomy & histology*
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Intubation, Intratracheal / methods*
  • Male
  • Nose*
  • Observer Variation
  • Prospective Studies
  • Radiography
  • Thailand
  • Trachea / anatomy & histology
  • Trachea / diagnostic imaging