Whyte K L, Levin R, Powls A
Neonatology Department, Princess Royal Maternity Hospital, 16 Alexandra Parade, Glasgow G31 2ER, UK.
Scott Med J. 2007 May;52(2):25-7. doi: 10.1258/rsmsmj.52.2.25.
The malposition of endotracheal tubes (ETTs) can be associated with endo-bronchial intubation or accidental extubation. A variety of methods have been reported for predicting insertional length (IL) including weight, nasal-tragus length (NTL) and sternal length (STL) measurements. In our unit no consistent predictor method was being used.
To audit the proportion of endotracheal tubes that required a significant position change after oral intubation. Our standard set was that the endotracheal tube should be in a satisfactory position in > 80% of cases. If not met, practice would then be re-audited after a consistent predictor method had been implemented.
Data regarding changes in endotracheal tube position were collected. Significant position changes were defined as adjustments > 0.5 cm.
Twenty two babies were included in the initial audit, and only 73% of endotracheal tubes had a satisfactory position. Thirty six babies were included in the re-audit and when the nasal-tragus length predictor was used, 94% of endotracheal tubes had a satisfactory position, meeting the standard.
The nasal-tragus length predictor improved the accuracy of endotracheal tube positioning after oral intubation. It is a simple, fast, reproducible method and can be used in everyday practice to help avoid significant endotracheal tube malposition.
气管内插管（ETT）位置不当可能与支气管内插管或意外拔管有关。已报道了多种预测插入长度（IL）的方法，包括体重、鼻-耳屏长度（NTL）和胸骨长度（STL）测量。在我们科室，尚未使用一致的预测方法。
审核经口插管后需要显著改变位置的气管内插管的比例。我们设定的标准是，在超过80%的病例中，气管内插管应处于满意位置。如果未达到该标准，则在实施一致的预测方法后对操作进行重新审核。
收集有关气管内插管位置变化的数据。显著的位置变化定义为调整超过0.5厘米。
22名婴儿纳入初始审核，只有73%的气管内插管位置满意。36名婴儿纳入重新审核，当使用鼻-耳屏长度预测方法时，94%的气管内插管位置满意，达到了标准。
鼻-耳屏长度预测方法提高了经口插管后气管内插管定位的准确性。它是一种简单、快速、可重复的方法，可用于日常实践中，以帮助避免气管内插管显著位置不当。
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