The Utility of Oro-Helical Length for Estimation of The Optimal Endotracheal Tube Insertion Depth in Neonates

Abstract

Background: Although endotracheal intubation is an emergency procedure that is frequently performed in neonatal care, there is still uncertainty about the best method for the estimation of the optimal depth of the endotracheal tube (ETT) in neonates. We aimed to compare two different methods of estimation of ETT insertion depth in neonates.Methods: This study was conducted on 120 neonates needing intubation. The ETT insertion depth was estimated in 60 neonates according to the oro-helical length (OHL) method and it was estimated in the other 60 neonates according to the Tochen’s formula method. Both groups were compared in correct estimation of the proper ETT position in chest radiography.Results: The incidence of ETT malposition did not differ significantly between the OHL group (31.7 %) and the Tochen’s formula group (45 %) (P > 0.05). There was also no significant difference in chest expansion in both groups in chest X ray. Two neonates in the OHL group developed air leaks (3.3 %) versus 3 neonates in Tochen’s formula group (5 %) with no significant difference (P > 0.05). Furthermore, there was no significant difference between both methods regarding the incidence of accidental extubation, There was a positive correlation between the estimated ETT insertion depth by OHL measurement and weight and gestational age (p < 0.001).Conclusion: The OHL measurement can be used as an alternative to Tochen’s formula for estimation of the optimal ETT insertion depth especially in emergency situations when the weight of the baby is not known.

Keywords

• ett
• intubation
• ohl
• resuscitation
• tochen’s formula