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Evaluation of body parameters for estimation of endotracheal tube length in Indian neonates

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Abstract

The objectives were to estimate the incidence of inadequate placement of the endotracheal tube (ET) using Tochen’s formula (6 + birth weight) and to correlate optimum ET length with anthropometric measurements in neonates. A cross-sectional analytical study was conducted in 50 neonates. Neonates requiring intubation for ventilation, with a confirmatory chest radiograph, were intubated using Tochen’s formula, after which tube placement was verified by auscultation. The incidence of inadequate placement and optimum length of ET insertion were estimated from chest radiographs. Anthropometric parameters were measured and correlated with the optimum length and regression equations generated. The incidence of inadequate placement of the ET was 40 % (20 of 50). The incidence of inadequate placement was higher (5 of 6, 83 %) in extremely low birth weight (ELBW) infants, and in extreme preterm infants (5 of 5, 100 %). It was found that all the anthropometric parameters correlated well (r between 0.71 and 0.84) with the optimum ET length. Conclusion: The incidence of inadequate placement was high, especially in the ELBWs’ and extreme preterm infants. Birth weight, sternal length, and shoulder umbilical length correlated significantly with optimum ET length and may guide optimal ET placement.

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Abbreviations

AL:

Arm length

BW:

Birth weight

DV:

The principal investigator

ELBW:

Extremely low birth weight

ET:

Endotracheal tube

FL:

Foot length

LBW:

Low birth weight

NICU:

Neonatal intensive care unit

NL:

Neonatal length

NRP:

Neonatal Resuscitation Program

NTL:

Nasal tragal length

OFC:

Occipitofrontal head circumference

SL:

Sternal length

SN:

The neonatal consultant

SUL:

Sternal umbilical length

ShUL:

Shoulder umbilical length

T1:

First thoracic vertebra

T2:

Second thoracic vertebra

T3:

Third thoracic vertebra

T4:

Fourth thoracic vertebra

T5:

Fifth thoracic vertebra

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

This study has been approved by the institutional ethical review board and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Written informed consent was taken from the parents or guardians of the neonate before collecting data.

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Authors and Affiliations

  1. St. John’s Medical College, Bangalore, India

    Dharamveer Tatwavedi

  2. Department of Neonatology, St. John’s Medical College Hospital, Sarjapur Road, Bangalore, 560034, India

    Saudamini Vijay Nesargi, Suman Rao & Swarna Rekha Bhat

  3. Department of Anatomy, St. John’s Medical College, Bangalore, India

    Nachiket Shankar

Authors
  1. Dharamveer Tatwavedi
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  2. Saudamini Vijay Nesargi
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  3. Nachiket Shankar
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  4. Suman Rao
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  5. Swarna Rekha Bhat
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Corresponding author

Correspondence to Saudamini Vijay Nesargi.

Additional information

Communicated by Patrick Van Reempts

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Tatwavedi, D., Nesargi, S.V., Shankar, N. et al. Evaluation of body parameters for estimation of endotracheal tube length in Indian neonates. Eur J Pediatr 174, 245–249 (2015). https://doi.org/10.1007/s00431-014-2388-1

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  • DOI: https://doi.org/10.1007/s00431-014-2388-1

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