New Formula for Nasal Endotracheal Intubation in Extremely Low-Birth Weight Infants in the Emergency Transport Setting: The "Genoa Formula".

Carlo Bellini, Paolo Massirio, Giulia Polleri, Marta Mambelli, Laura Costanza De Angelis, Chiara Andreato, Maria Grazia Calevo, Federica Mongelli, Diego Minghetti, Luca A Ramenghi

Air Medical Journal · 2020-12-15 · Observational study

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Abstract

OBJECTIVE: The purpose of this study was to find a predictive equation for estimating the optimal nasal endotracheal tube insertion depth in extremely low-birth weight infants (ELBWs) requiring invasive ventilation in the critical care interfacility transport setting. METHODS: We retrospectively calculated the optimal tube insertion depth in a cohort of neonates ≤ 1,000 g born at our neonatal intensive care unit and nasally intubated within the first 24 hours of life from January 2019 to May 2020. RESULTS: A total of 75 ELBW infants were included, with a median gestational age of 26.6 weeks (range, 22.1-32.6 weeks) and a median birth weight of 780 g (range, 410-990 g). The linear regression of the estimated optimal endotracheal tube insertion depth showed a good correlation when plotted against weight (R2 = 0.491); thus, a new weight-based formula was obtained. CONCLUSION: The proposed weight-based formula (the "Genoa formula") may help in predicting optimal insertion depths for nasal intubation in ELBW neonates, especially when a prompt radiologic confirmation of the tube position is not available, as during neonatal critical care transport.

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Tags

Interfacility & critical care transport · Endotracheal intubation · Neonates

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