Randomized controlled trial (RCT) comparing between shoulder umbilicus length versus body weight measurement for optimal endotracheal tube (ETT) depth in ventilated infants
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Date
2020
Authors
Ali, Adam Al-Anas Mat
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia
Abstract
INTRODUCTION: The optimal placement of the endotracheal tube (ETT) in ventilated
neonates is essential but birth weight (BW) may be not the best parameter to predict it. A
previous study suggested that shoulder umbilical length (SUL) might be superior. The aim of
this study is a direct comparison between SUL vs. BW as predictor of optimal ETT
placement in Malaysian ventilated neonates.
METHODS: All neonates requiring ventilation in the NICU of Hospital Universiti Sains
Malaysia during the 5 months study period were eligible to enter this randomized controlled
trial. Babies included in this study were randomized in two groups: the tube depth was
determined based on the SUL for the intervention group and based on the BW for the control
group. The main outcome measure was mal-positioning of the ETT as seen on the chest x-ray
performed within 1 hour after intubation. Tube placement was assessed by two
neonatologists, blinded to the allocation. Data were analysed using SPSS, version 24.
RESULTS: One hundred and ten (110) babies were randomized, 55 in each group. The ETT
was mal-positioned (requiring adjustment in 13/55 babies (23%) for the SUL group and
22/55 babies (40%) in the BW group (p=0.06)
CONCLUSION: In the SUL group, less babies showed a need for tube adjustment than in the
BW group. The difference did not reach statistical significance. While, a larger study may be
necessary to show statistical significance, the difference shown in this study may be large
enough to be of clinical significance.
Description
Keywords
shoulder-umbilical length