Laryngoscopy and Endotracheal Intubation

  • Karen Wiseman
  • Steven M. DonnEmail author
  1. I.
    Indications for intubation
    1. A.

      Need for prolonged positive pressure ventilation for respiratory failure.

    2. B.

      Inability to provide effective bag and mask ventilation.

    3. C.

      Need for administration of surfactant.

    4. D.

      Apnea, either central, or obstructive.

    5. E.
      Airway maintenance.
      1. 1.

        Anatomic anomalies of the airway, such as choanal atresia, micrognathia, laryngomalacia, laryngeal web, or vocal cord paralysis

      2. 2.

        Compressive lesions on the airway, such as cystic hygroma or hemangioma

      3. 3.

        Airway protection in cases of congenital neuromuscular disorders or other neurologic injury

    6. F.

      Congenital diaphragmatic hernia. Avoidance of mask ventilation and delivery of air into the gastrointestinal tract is critical, and immediate intubation should be performed.

  2. II.
    Endotracheal tube diameter
    1. A.
      Size of tube (internal diameter, mm):

      Up to 1,000 g


      1,001–2,000 g


      2,001–3,000 g


      >3,000 g



Vocal Cord Congenital Diaphragmatic Hernia Mask Ventilation Nondominant Hand Choanal Atresia 
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Suggested Reading

  1. Donn SM, Blane CE. Endotracheal tube movement in the preterm infant: oral versus nasal intubation. Ann Otol Rhinol Laryngol. 1985;94:18–20.PubMedGoogle Scholar
  2. Donn SM, Engmann C. Neonatal resuscitation: special procedures. In: Donn SM, editor. The Michigan Manual – A guide to neonatal intensive care. 3rd ed. Philadelphia, PA: Hanley & Belfus; 2003. p. 33–4.Google Scholar
  3. Donn SM, Kuhns LR. Mechanism of endotracheal tube movement with change of head position in the neonate. Pediatr Radiol. 1980;9:37–40.PubMedCrossRefGoogle Scholar
  4. Hancock PJ, Peterson G. Finger intubation of the trachea in newborns. Pediatrics. 1992 Feb;89(2):325–7.PubMedGoogle Scholar
  5. Sarkar S, Schumacher RE, Baumgart S, Donn SM. Are newborns receiving premedication before elective intubation? J Perinatol. 2006;26(5):286–9.PubMedCrossRefGoogle Scholar
  6. Woody NC, Woody HB. Direct digital intubation for neonatal resuscitation. J Pediatr. 1968;73:47–5.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Division of Neonatal–Perinatal MedicineC.S. Mott Children’s Hospital, University of Michigan Health SystemAnn ArborUSA
  2. 2.Division of Neonatal–Perinatal MedicineC.S. Mott Children’s Hospital, F5790 Mott Hospital/5254, University of Michigan Health SystemAnn ArborUSA

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