Highlights
- •Nasal endotracheal intubation is a challenging procedure in extremely low–birth weight infants.
- •This is particularly true in the acute neonatal transport setting when a prompt radiologic confirmation of the tube position is not available.
- •We propose a new weight-based equation to obtain the midtracheal position of the endotracheal tube tip for nasal intubation of extremely low–birth weight infants (the “Genoa formula”).
Abstract
Objective
The purpose of this study was to find a predictive equation for estimating the optimal
nasal endotracheal tube insertion depth in extremely low–birth weight infants (ELBWs)
requiring invasive ventilation in the critical care interfacility transport setting.
Methods
We retrospectively calculated the optimal tube insertion depth in a cohort of neonates
≤ 1,000 g born at our neonatal intensive care unit and nasally intubated within the
first 24 hours of life from January 2019 to May 2020.
Results
A total of 75 ELBW infants were included, with a median gestational age of 26.6 weeks
(range, 22.1-32.6 weeks) and a median birth weight of 780 g (range, 410-990 g). The
linear regression of the estimated optimal endotracheal tube insertion depth showed
a good correlation when plotted against weight (R2 = 0.491); thus, a new weight-based formula was obtained.
Conclusion
The proposed weight-based formula (the “Genoa formula”) may help in predicting optimal
insertion depths for nasal intubation in ELBW neonates, especially when a prompt radiologic
confirmation of the tube position is not available, as during neonatal critical care
transport.
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Article info
Publication history
Published online: December 15, 2020
Footnotes
The present study is part of an MD degree thesis (M.M.) and a postdoctoral thesis (G.P.).
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of Air Medical Journal Associates.
