Iranian Journal of Neonatology

Iranian Journal of Neonatology

The Utility of Oro-Helical Length for Estimation of The Optimal Endotracheal Tube Insertion Depth in Neonates

Document Type : Original Article

Authors
Dina Mohamed Shinkar 1
Abeer Salah Eldin El Sakka 1
Maha Abdel Raouf Abdel Hafiz 2
1 Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Ministry of Health, Cairo, Egypt
10.22038/ijn.2024.76554.2480
Abstract
Background: Although endotracheal intubation is an emergency procedure that is frequently performed in neonatal care, there is still uncertainty about the best method for the estimation of the optimal depth of the endotracheal tube (ETT) in neonates. We aimed to compare two different methods of estimation of ETT insertion depth in neonates.
Methods: This study was conducted on 120 neonates needing intubation. The ETT insertion depth was estimated in 60 neonates according to the oro-helical length (OHL) method and it was estimated in the other 60 neonates according to the Tochen’s formula method. Both groups were compared in correct estimation of the proper ETT position in chest radiography.
Results: The incidence of ETT malposition did not differ significantly between the OHL group (31.7 %) and the Tochen’s formula group (45 %) (P > 0.05). There was also no significant difference in chest expansion in both groups in chest X ray.  Two neonates in the OHL group developed air leaks (3.3 %) versus 3 neonates in Tochen’s formula group (5 %) with no significant difference (P > 0.05). Furthermore, there was no significant difference between both methods regarding the incidence of accidental extubation, There was a positive correlation between the estimated ETT insertion depth by OHL measurement and weight and gestational age (p < 0.001).
Conclusion: The OHL measurement can be used as an alternative to Tochen’s formula for estimation of the optimal ETT insertion depth especially in emergency situations when the weight of the baby is not known.
 
Keywords
ETT
Intubation
OHL
Resuscitation
Tochen’s formula 
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Iranian Journal of Neonatology
Volume 15, Issue 2
Spring 2024
Pages 20-27