Comparison of Clinical Endotracheal Tube Depths with Standard Estimates for the Stabilization of Infants with Congenital Diaphragmatic Hernia.

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY American journal of perinatology Pub Date : 2025-02-01 Epub Date: 2024-07-22 DOI:10.1055/a-2370-2035

Allison C Young, Joseph L Hagan, Shweta S Parmekar, Pamela M Ketwaroo, Nathan C Sundgren

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Abstract

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

Key points: · CDH patients present unique stabilization challenges.. · Standard ETT depth estimates are too shallow.. · Resuscitation teams should cautiously choose ETT depth..

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比较临床气管导管深度和标准估计值，以稳定先天性膈疝婴儿的病情。

目的：比较先天性膈疝（CDH）患儿初步稳定后的临床气管插管（ETT）深度：比较先天性膈疝（CDH）婴儿初步稳定后的临床气管导管（ETT）深度与基于体重和胎龄的深度估计值：这项回顾性分析包括 58 名左侧 CDH 新生儿。我们比较了根据初始胸片计算出的标准解剖 ETT 深度，以及根据体重和胎龄估算的预测深度调整后的临床 ETT 深度：结果：标准解剖深度比胎龄深度要深（1.29 厘米 ± 1.15 标准差，p）：预测 ETT 深度的既定策略低估了左侧 CDH 婴儿的理想深度。这些数据表明，在根据标准深度估计值为 CDH 患者初次置入 ETT 时应谨慎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.