Endotracheal Tube Placement in Infants

PEDIATRICS ◽  
1986 ◽  
Vol 77 (1) ◽  
pp. 132-132
Author(s):  
RICHARD M. HELLER ◽  
ROBERT B. COTTON
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Endotracheal Tube ◽  
Neonatal Intensive Care ◽  
Tube Placement ◽  
Clear Indication ◽  
Depth Of Penetration ◽  
Endotracheal Tubes ◽  
Endotracheal Tube Placement ◽  
The Cost

In Reply.— We agree with Dr Bloch that auscultation is a primary tool for determinig appropriate position of an endotracheal tube. However, experience in a busy neonatal intensive care unit has shown that, even with careful auscultation, endotracheal tubes still become inappropriately positioned, often with serious consequences. Our experience has been that the illuminated endotracheal tube provides a clear indication of depth of penetration when asymmetric lung disease may cause auscultatory findings to be equivocal. Dr Goldenring raises the important point that the cost of the illuminated endotracheal tube is under evaluation at the present time, and as soon as information concerning pricing is available, I will make this information available to the readership of Pediatrics.

EVALUATION OF AN OPTICAL FIBER SCOPE TO CONFIRM ENDOTRACHEAL TUBE PLACEMENT IN PEDIATRIC INTENSIVE CARE UNIT PATIENTS

1998 ◽  
Vol 26 (Supplement) ◽  
pp. 113A
Author(s):  
Gerardo Reyes ◽  
Marlene Steffen ◽  
Anne Freter ◽  
Ira Horowitz ◽  
Jose L. Ramilo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Optical Fiber ◽  
Endotracheal Tube ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Tube Placement ◽  
Endotracheal Tube Placement

Neonatal & Paediatric Point Of Care Ultrasound (Pocus): A Novel Standard Practice

2021 ◽  
Vol 8 (3) ◽  
pp. 124-131
Author(s):  
Dr. Abhijit Shinde ◽  
Dr. Sushrut Kumar ◽  
Dr. Sneha Mhaske
Keyword(s):  
Intensive Care ◽  
Endotracheal Tube ◽  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Developed Countries ◽  
Tube Placement ◽  
Point Of Care Ultrasound ◽  
Standard Practice ◽  
Endotracheal Tube Placement ◽  
Growing Body

An ever expanding branch of applications have been developed for ultrasound, including its goal directed use at the bedside, often called point-of-care ultrasound (POCUS). ).  Although neonatologist-performed functional echocardiography has been at the frontline of the worldwide growth of POCUS, a rapidly growing body of evidence has also demonstrated the importance of non-cardiac applications, including guidance of placement of central catheterisation and lumbar puncture, endotracheal tube localisation as well as rapid estimation of the brain, lungs, bladder and bowel.  Ultrasonography has become a pivotal adjunct to the care of neonates in the neonatal intensive care unit (NICU); but a full appreciation for its diagnostic capabilities in the NICU is lacking.(2) Ultrasonography (USG) is no longer the exclusive domain of radiologists and cardiologists. With appropriate training, clinician performed ultrasound (CPU) is now practised widely in obstetrics, emergency medicine and adult intensive care .In many developed countries,it is standard practice in neonatology. (3) In this review, we will discuss neonatal & pediatric point of care ultrasound (POCUS) as a novel standard practice & its clinical application for assessment of the head, heart, lung, gut, bladder, for vascular line localization & for endotracheal tube placement. As new applications and adoption of point-of-care ultrasound continues to gain acceptance in paediatric and neonatal medicine throughout the world, a rapidly growing body of evidence suggests that the result will be faster, safer and more successful diagnosis and treatment of our  patients.

Endotracheal tube manipulation during cardiopulmonary resuscitation in the neonatal intensive care unit

2021 ◽  
Author(s):  
Kaashif A. Ahmad ◽  
Cody L. Henderson ◽  
Steven G. Velasquez ◽  
Jaclyn M. LeVan ◽  
Katy L. Kohlleppel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Neonatal Intensive Care Unit ◽  
Endotracheal Tube ◽  
Neonatal Intensive Care

Endotracheal tube narrowing after closed-system suctioning: prevalence and risk factors

1999 ◽  
Vol 8 (2) ◽  
pp. 93-100 ◽  
Author(s):  
C Glass ◽  
MJ Grap ◽  
CN Sessler
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Endotracheal Tube ◽  
Closed System ◽  
Contributing Factors ◽  
Tube Size ◽  
Endotracheal Tubes ◽  
Few Data ◽  
Endotracheal Tube Size

BACKGROUND: Few data exist about buildup of secretions within endotracheal tubes of patients treated with closed-system suctioning in the intensive care unit. OBJECTIVES: To describe the extent, prevalence, and distribution of narrowing of endotracheal tubes related to buildup of secretions and to determine contributing factors. METHODS: Forty endotracheal tubes were examined within 4 hours of extubation, after at least 72 hours of use. Data on patients' daily weight and fluid balance, ventilator humidification temperatures, and nurses' descriptions of secretions during the 3 days preceding extubation were recorded. Any secretion debris in the endotracheal tubes was weighed. At 1-cm intervals along the tube, the debris was described and the depth of the debris was measured to the nearest 0.5 mm. RESULTS: Mean duration of intubation was 6.6 days. Two tubes had no debris. Mean overall depth of debris was 0.64 mm, mean greatest depth was 2.0 mm (range, 0-5 mm), and mean weight was 1.16 g. The entire tube was affected, with the greatest depth of debris at the 6- to 9-cm and 13- to 14-cm markings. Duration of intubation correlated with mean greatest depth of debris (r = 0.37, P = .02), mean overall depth of debris (r = 0.48, P = .002), and mean weight of debris (r = 0.38, P = .02). CONCLUSIONS: Endotracheal tubes are markedly narrowed by the buildup of secretions after closed-system suctioning. Duration of intubation, but not endotracheal tube size or amount of secretions, was associated with the degree of narrowing.

Endotracheal Tube Placement in Infants

PEDIATRICS ◽  
1986 ◽  
Vol 77 (1) ◽  
pp. 131-131
Author(s):  
EDMOND C. BLOCH
Keyword(s):  
Endotracheal Tube ◽  
Light Source ◽  
Early Experience ◽  
Tube Placement ◽  
Term Infants ◽  
Endotracheal Tubes ◽  
Endotracheal Tube Placement

To the Editor.— A recent article1 inPediatrics describing the early experience with illuminated endotracheal tubes in premature and term infants is of considerable interest. The idea is certainly a novel one and would probably appeal to many. However, it does require a specially designed endotracheal tube and fiberoptic light source, both of which may not be available. I would like to describe a method that I have been using for many years and that I have found most reliable.

scholarly journals Admission clinicopathological data, length of stay, cost and mortality in an equine neonatal intensive care unit

2007 ◽  
Vol 78 (3) ◽  
Author(s):  
M.N. Saulez ◽  
B. Gummow ◽  
N.M. Slovis ◽  
T.D. Byars ◽  
M. Frazer ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Laboratory Data ◽  
Anion Gap ◽  
Wbc Count ◽  
The Cost

Veterinary internists need to prognosticate patients quickly and accurately in a neonatal intensive care unit (NICU). This may depend on laboratory data collected on admission, the cost of hospitalisation, length of stay (LOS) and mortality rate experienced in the NICU. Therefore, we conducted a retrospective study of 62 equine neonates admitted to a NICU of a private equine referral hospital to determine the prognostic value of venous clinicopathological data collected on admission before therapy, the cost of hospitalisation, LOS and mortality rate. The WBC count, total CO2 (TCO2) and alkaline phosphatase (ALP) were significantly higher (P < 0.05) and anion gap lower in survivors compared with nonsurvivors. A logistic regression model that included WBC count, hematocrit, albumin / globulin ratio, ALP, TCO2, potassium, sodium and lactate, was able to correctly predict mortality in 84 % of cases. Only anion gap proved to be an independent predictor of neonatal mortality in this study. In the study population, the overall mortality rate was 34 % with greatest mortality rates reported in the first 48 hours and again on day 6 of hospitalisation. Amongst the various clinical diagnoses, mortality was highest in foals after forced extraction during correction of dystocia. Median cost per day was higher for nonsurvivors while total cost was higher in survivors.

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