title: Estimating the endotracheal tube insertion depth in newborns using weight or gestation: a randomised trial.
abstract: BACKGROUND
  When intubating newborns, clinicians aim to place the tip of the endotracheal tube (ETT) in the mid-trachea. Clinicians usually estimate the ETT insertion depth based on weight. ETT tips are often incorrectly positioned in newborns. Estimating the insertion depth based on gestation may be more accurate.
  
  
  OBJECTIVE
  To determine whether estimating the ETT insertion depth using gestation, compared to weight, results in more correctly placed ETTs.
  
  
  METHODS
  Newborn infants without congenital anomalies who were intubated orally were randomised to having their ETT insertion depth estimated using weight [insertion depth (cm) = weight (kg) + 6] or gestation [value determined from a table]. The primary outcome was correct ETT position, defined as an ETT tip between the upper border of the first thoracic vertebra (T1) and the lower border of the second thoracic vertebra (T2) on a chest X-ray. The primary outcome was determined by one paediatric radiologist who was masked to group assignment.
  
  
  RESULTS
  Ninety infants were enrolled and the groups were well matched. The proportion of correctly placed ETTs was not significantly different between the groups [weight, 25/49 (51%), vs. gestation, 16/41 (39%), p = 0.293]. We found no significant differences in the secondary outcomes measured.
  
  
  CONCLUSIONS
  Estimating the ETT insertion depth in newborns using gestation compared to weight did not result in more correctly placed ETTs.
authors.forename: Aisling M
authors.initials: AM
authors.lastname: Flinn
authors.forename: Colm P
authors.initials: CP
authors.lastname: Travers
authors.forename: Eoghan E
authors.initials: EE
authors.lastname: Laffan
authors.forename: Colm P F
authors.initials: CP
authors.lastname: O'Donnell
mesh_terms: D001835:Body Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D011859:Radiography; D014132:Trachea / Q000000981:diagnostic imaging*; D016896:Treatment Outcome