Normative Data of Optimally Placed Endotracheal Tube by Point-of-care Ultrasound in Neonates.

OBJECTIVE: To derive normative data of the distance between optimally placed endotracheal tube tip and arch of aorta by ultrasound in neonates across different weight and gestation. DESIGN: Cross-sectional study. SETTING: Tertiary care neonatal intensive care unit from April 2015 to May 2016. PARTICIPANTS: All neonates requiring endotracheal intubation were eligible for the study. METHODS: During intubation, insertional length was determined using weight-based formula. The distance between endotracheal tube tip and arch of aorta was measured by ultrasound. Endotracheal tube position was confirmed by chest radiograph. RESULTS: Out of 133 enrolled infants, 101 (75.9%) had optimally placed endotracheal tubes. The mean (SD) distance between endotracheal tube tip and arch of aorta by ultrasound was 0.78 (0.21) cm in infants <1500 g and 1.04 (0.32) cm in infants ≥1500 g. The regression equation to estimate insertional length from weight, crown heel length (CHL), occipito-frontal circumference (OFC), nasal tragus length (NTL) and sternal length (SL) were Wt(kg)+4.95, 0.15×CHL(cm)+0.57, 0.22×OFC(cm)+0.49, 0.82× NTL(cm)+1.24 and 0.75×SL(cm)+2.26, respectively. CONCLUSIONS: Our study reports normative data of the distance between optimally placed endotracheal tube tip and arch of aorta by ultrasound in neonates. The distance between endotracheal tube tip and arch of aorta increases with increase in weight and gestation. Insertional length correlates strongly with all the anthropometric parameters.