Background: Endotracheal tube (ETT) tip position is determined on chest X-ray (CXR) and should lie between the upper border of the first thoracic vertebra (T1) and the lower border of second thoracic vertebra (T2). Infant weight is commonly used to estimate how far the ETT should be inserted but frequently results in malpositioned ETT tips. Palpation of the ETT tip at the suprasternal notch has been recommended as an alternative.
Objective: To determine whether estimating ETT insertion depth using suprasternal palpation of the ETT tip rather than weight results in more correctly positioned ETT tips.
Design: Single-centre randomised controlled trial.
Setting: Level III neonatal intensive care unit (NICU) at a university maternity hospital.
Patients: Newborn infants without congenital anomalies intubated in the NICU.
Interventions: Participants were randomised to have ETT insertion depth estimated using palpation of the ETT tip at the suprasternal notch or weight [insertion depth (cm)=6 + wt (kg)].
Main Outcome Measure: Correct ETT position, that is, between the upper border of T1 and lower border of T2 on CXR, determined by one consultant paediatric radiologist masked to group assignment.
Results: There was no difference in the proportion of correctly placed ETT tips between the groups (suprasternal palpation 27/58 (47%) vs weight 23/60 (38%), p=0.456). Most incorrectly positioned ETTs were too low (56/68 (82%)).
Conclusion: Estimating ETT insertion depth using suprasternal palpation did not result in more correctly positioned ETTs.
Trial Registration Number: ISRCTN13570106.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1136/archdischild-2019-317328 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
SUMMER: an integrated nanopore sequencing pipeline for variants detection and clinical annotation on the human genome.
Funct Integr Genomics
January 2025
Children's Medical Center, Peking University First Hospital, No.5 Le Yuan Road, Daxing District, 100034, Beijing, China.
Long-read sequencing has emerged as a transformative technology in recent years, offering significant potential for the molecular diagnosis of unresolved genetic disorders. Despite its promise, the comprehensive detection and clinical annotation of genomic variants remain intricate and technically demanding. We present SUMMER, an integrated and structured workflow specifically designed to process raw Nanopore sequencing reads.
View Article and Find Full Text PDFComparative evaluation of submerged versus nonsubmerged dental implants - A prospective, clinico-radiographic, split-mouth study.
Natl J Maxillofac Surg
November 2024
Department of Oral and Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India.
Background: To minimize the risk of impaired osseointegration historically, it has been recommended to insert the implant into the bone (submerged implants) and to allow for submerged healing of 3-6 months in the lower and upper jaw, this conventional technique is advocated. The concept of nonsubmerged healing was introduced in 1988 in which gingival former was placed at the time of implant placement instead of cover screw. The treatment concept of nonsubmerged implant placement enables early implant loading, one surgical procedure only, and a reduced treatment period for the patients.
View Article and Find Full Text PDFEvaluation of the safety profile of amivantamab based on real-world evidence: a call to vigilance.
Expert Opin Drug Saf
January 2025
Department of Pharmacy, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
Background: Amivantamab has been approved for EGFR exon 20 insertion-mutated non-small-cell lung cancer. The aim of this study was to perform an in-depth analysis of its safety profile.
Research Design And Methods: Safety reports were collected from the database of the Food and Drug Administration Adverse Event Reporting System from April 2021 to September 2023, and the reporting odds ratio (ROR) method was used to detect potential safety signals.
Direct anastomosis indwelling needle puncture: a rapid and safe transitional hemodialysis access for patients with renal failure.
Ren Fail
December 2025
Department of Nephrology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Objectives: Vascular access thrombosis (VAT) is a common complication in patients with end-stage renal disease (ESRD), significantly impacting hemodialysis efficacy and patient survival. Currently, temporary dialysis access is typically established deep vein catheterization (VC), however, this method is highly invasive and associated with risks of infection and other complications. This study aims to explore the feasibility of using direct anastomosis indwelling needle puncture (DAINP) for temporary dialysis access.
View Article and Find Full Text PDFAnatomical investigation of safety determining factors for keyhole drilling trajectories for robotic cochlear implant surgery.
Eur Arch Otorhinolaryngol
January 2025
Vrije Universiteit Brussel, Brussels Health Centre, Brussels, Belgium.
Purpose: Cochlear implants (CI) are the most successful bioprosthesis in medicine probably due to the tonotopic anatomy of the auditory pathway and of course the brain plasticity. Correct placement of the CI arrays, respecting the inner ear anatomy are therefore important. The ideal trajectory to insert a cochlear implant array is defined by an entrance through the round window membrane and continues as long as possible parallel to the basal turn of the cochlea.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!