CHEST X-RAY TO DETERMINE ENDOTRACHEAL TUBE PLACEMENT PRIOR TO FIXED WING TRANSPORT

Introduction: Neonatal intubation is done for cardiopulmonary resuscitation, hypoxemia, and hypercapnia, for surfactant therapy or for airway protection. When correctly placed, endotracheal tube (ETT) tip should be at mid tracheal position which is half way between the clavicles and the carina to prevent complications of ventilation. Objective: To assess the accuracy of 7-8-9 Rule in neonates at Kanti Children’s hospital. Methodology: Prospective observational study was conducted in neonates who required oral intubations from July 2009 to December 2009 at NICU of Kanti Children’s Hospital. The initial ETT depth of insertion was determined using admission weight in the 7-8-9 Rule calculation. This depth was compared to the midtracheal depth to determine clinical accuracy of the 7-8-9 Rule. Results: Mean gestation age of the 69 infants was 36.01 weeks (26 to 42 weeks) and weight was 2411 g( 900 g to 3800 g ). 7 (10.1%) neonates weighed 1000 g or less, 19 (27.5%) weighed between 1001 to 2000 g, 31 ( 44.9%) weighed between 2001 to 3000 g, 12(17.4%) weighed between 3001 to 4000 g. The accuracy of 7-8-9 rule in clinical setting with auscultation and Chest x-ray resulted in ETT depth 0.11 cm above midtracheal position. (-1.5 to 1.5 cm). Using this rule ET tube was placed 0.11 cm above the mid tracheal position. Conclusions: The 7-8-9 Rule appears to be an accurate clinical method for endotracheal tube placement in Nepalese neonates. Keywords: Intubation; Neonate; Mid Tracheal Position DOI: http://dx.doi.org/10.3126/jnps.v31i3.4299 J Nep Paedtr Soc 2011;31(3): 175-179

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Pilot Study to Evaluate the Accuracy of Ultrasonography in Confirming Endotracheal Tube Placement

Ultrasound Quarterly ◽

10.1097/01.ruq.0000263829.79992.e5 ◽

2007 ◽

Vol 23 (1) ◽

pp. 43

Author(s):

&NA;

Keyword(s):

Pilot Study ◽

Endotracheal Tube ◽

Tube Placement ◽

Endotracheal Tube Placement

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Assessment of gas flow waves for endotracheal tube placement in an ovine model of neonatal resuscitation

Resuscitation ◽

10.1016/j.resuscitation.2010.02.018 ◽

2010 ◽

Vol 81 (6) ◽

pp. 737-741 ◽

Cited By ~ 13

Author(s):

G.M. Schmölzer ◽

S.B. Hooper ◽

K.J. Crossley ◽

B.J. Allison ◽

C.J. Morley ◽

...

Keyword(s):

Endotracheal Tube ◽

Gas Flow ◽

Neonatal Resuscitation ◽

Tube Placement ◽

Ovine Model ◽

Endotracheal Tube Placement

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THE SENSITIVITY, SPECIFICITY AND ACCURACY OF STATIC METHOD OF ULTRASONOGRAPHY TO CONFIRM ENDOTRACHEAL INTUBATION IN EMERGENCY DEPARTMENT.

10.36106/ijsr/6729269 ◽

2021 ◽

pp. 8-13

Author(s):

Pankaj Kumar Singh ◽

Budhaditya Sanyal ◽

Mohit Bhatnagar ◽

Mandeep Joshi ◽

Shreya Verma

Keyword(s):

Diagnostic Accuracy ◽

Endotracheal Tube ◽

Predictive Value ◽

Static Method ◽

Tube Placement ◽

Short Course ◽

Endotracheal Tube Placement ◽

Linear Probe ◽

Post Intubation ◽

Sensitivity Specificity

Aims and objectives: This study aims to assess the diagnostic accuracy and timeliness of ultrasonography by static method only for identication of Endotracheal tube (ET Tube) placement in the trachea in emergency settings vs existing clinical methods. Material and Methods: This prospective study was carried out in the emergency room from October 2018 till the end of March 2019. The ultrasonography was performed in 120 emergency patients only after the intubation had been completed ie, static phase. A linear probe was used over the neck to identify the predened signs of ET intubation. Residents who perform ultrasound examination ll a form after assessment of each patient. Results: It was found that Tracheal Intubation-USG Sensitivity was 99.1, Specicity was 91.7, Positive Predictive Value: 99.1, Negative Predictive Value was 91.7 and Accuracy was 98.3%. Ultrasonography can be used as an adjunct tool to verify the ETTposition by Emergency Physicians which can be performed easily after a brieng or short-course training.Conclusion:This study demonstrates that US imaging has a high diagnostic accuracy to immediately conrm proper ETT placement post-intubation in an emergency setup. Therefore, it seems that ultrasonography using a static technique only is a proper screening tool in determining endotracheal tube placement.

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Pulmonary atelectasis in newborns with clinically treatable diseases who are on mechanical ventilation: clinical and radiological aspects

Radiologia Brasileira ◽

10.1590/0100-3984.2016.0157 ◽

2018 ◽

Vol 51 (1) ◽

pp. 20-25 ◽

Cited By ~ 2

Author(s):

Mariana Chiaradia Dominguez ◽

Beatriz Regina Alvares

Keyword(s):

Mechanical Ventilation ◽

Endotracheal Tube ◽

Left Lung ◽

Hyaline Membrane Disease ◽

Relevant Information ◽

Tube Placement ◽

Cross Sectional ◽

Pulmonary Atelectasis ◽

Radiology Reports ◽

Endotracheal Tube Placement

Abstract Objective: To analyze the radiological aspects of pulmonary atelectasis in newborns on mechanical ventilation and treated in an intensive care unit, associating the characteristics of atelectasis with the positioning of the head and endotracheal tube seen on the chest X-ray, as well as with the clinical variables. Materials and Methods: This was a retrospective cross-sectional study of 60 newborns treated between 1985 and 2015. Data were collected from medical records and radiology reports. To identify associations between variables, we used Fisher's exact test. The level of significance was set at p < 0.05. Results: The clinical characteristics associated with improper positioning of the endotracheal tube were prematurity and a birth weight of less than 1000 g. Among the newborns evaluated, the most common comorbidity was hyaline membrane disease. Atelectasis was seen most frequently in the right upper lobe, although cases of total atelectasis were more common in the left lung. Malpositioning of the head showed a trend toward an association with atelectasis in the left upper lobe. Conclusion: Pulmonary atelectasis is a common complication in newborns on mechanical ventilation. Radiological evaluation of the endotracheal tube placement provides relevant information for the early correction of this condition.

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