Am J Perinatol

. 2024 Jul 22.

 doi: 10.1055/a-2370-2035. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/39038792/

Comparison of clinical endotracheal tube depths with standard estimates for the stabilization of infants with congenital diaphragmatic hernia

Allison C Young ¹, Joseph L Hagan ², Shweta S Parmekar ^1 3, Pamela M Ketwaroo ^4 5, Nathan C Sundgren ^1 3

Affiliations expand

• PMID: 39038792
• DOI: 10.1055/a-2370-2035

Abstract

Objective: To compare the clinical endotracheal tube (ETT) depth after initial stabilization of infants with congenital diaphragmatic hernia (CDH) to weight and gestational age-based depth estimates.

Study design: This retrospective analysis included 58 inborn infants with left-sided CDH. We compared a standard anatomic ETT depth calculated from initial chest radiographs and the clinical depth of the ETT after adjustments to predicted depths using weight and gestational age-based estimates.

Results: The standard anatomic depth was deeper than age (1.29 cm ± 1.15 standard deviation, p<0.001) and weight-based (0.59 cm ± 0.95 standard deviation, p<0.001) estimates. The clinical ETT depth was also deeper than age (1.01 cm ± 0.77 standard deviation, p<0.001) and weight-based (0.26 cm ± 0.50 standard deviation, p<0.001) estimates.

Conclusion: Established strategies to predict ETT depth underestimate the ideal depth in infants with left-sided CDH. These data suggest utilizing caution during initial ETT placement based on standard depth estimates for patients with CDH.

Thieme. All rights reserved.