Ali, Adam Al-Anas Mat
(2020)
Randomized controlled trial (RCT) comparing between
shoulder umbilicus length versus body weight measurement
for
optimal endotracheal tube (ETT) depth in ventilated infants.
Masters thesis, Universiti Sains Malaysia.
Abstract
INTRODUCTION: The optimal placement of the endotracheal tube (ETT) in ventilated
neonates is essential but birth weight (BW) may be not the best parameter to predict it. A
previous study suggested that shoulder umbilical length (SUL) might be superior. The aim of
this study is a direct comparison between SUL vs. BW as predictor of optimal ETT
placement in Malaysian ventilated neonates.
METHODS: All neonates requiring ventilation in the NICU of Hospital Universiti Sains
Malaysia during the 5 months study period were eligible to enter this randomized controlled
trial. Babies included in this study were randomized in two groups: the tube depth was
determined based on the SUL for the intervention group and based on the BW for the control
group. The main outcome measure was mal-positioning of the ETT as seen on the chest x-ray
performed within 1 hour after intubation. Tube placement was assessed by two
neonatologists, blinded to the allocation. Data were analysed using SPSS, version 24.
RESULTS: One hundred and ten (110) babies were randomized, 55 in each group. The ETT
was mal-positioned (requiring adjustment in 13/55 babies (23%) for the SUL group and
22/55 babies (40%) in the BW group (p=0.06)
CONCLUSION: In the SUL group, less babies showed a need for tube adjustment than in the
BW group. The difference did not reach statistical significance. While, a larger study may be
necessary to show statistical significance, the difference shown in this study may be large
enough to be of clinical significance.
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