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Randomised controlled trial: Shoulder–umbilicus length versus body weight measurement for optimal endotracheal tube depth estimation in ventilated infants
Author(s) -
Mat Ali Adam AlAnas bin,
Nasir Ariffin,
Ramli Noraida,
Ibrahim Nor R,
Van Rostenberghe Hans
Publication year - 2020
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.14705
Subject(s) - medicine , umbilicus (mollusc) , intubation , mechanical ventilation , randomized controlled trial , endotracheal tube , neonatal intensive care unit , statistical significance , endotracheal intubation , pediatrics , anesthesia , surgery
Aim The optimal placement of the endotracheal tube (ETT) in ventilated infants is essential, but birthweight may be not the best parameter to predict it. The aim of this study was a direct comparison of shoulder–umbilical length (experimental group) versus birthweight (control group) as predictor of optimal ETT placement in Malaysian ventilated infants. Methods All infants requiring ventilation in the neonatal intensive care unit of a tertiary hospital in Malaysia during the 4‐month study period were eligible to enter this randomised controlled trial. All participants were randomised into two groups: experimental and control group. The main outcome measure was malposition of the ETT (requiring adjustment), as seen on the chest X‐ray performed within 1 h after intubation. Tube placement was assessed by two neonatologists, blinded to the allocation. Results One hundred and ten infants were randomised, 55 in each group. The ETT was malpositioned in 13 of 55 infants (23%) for the experimental group and 22 of 55 infants (40%) in the control group ( P = 0.06). Conclusion In the experimental group, fewer infants showed a need for tube adjustment than in the control group. While a larger study may be necessary to show statistical significance, the difference shown in this study may be large enough to be of clinical significance.