Assessment of endotracheal tube placement in newborn infants: a randomized controlled trial

Journal of Perinatology : Official Journal of the California Perinatal Association
S van OsG M Schmölzer

Abstract

International resuscitation guidelines recommend clinical assessment and exhaled CO2 to confirm tube placement immediately after intubation. However, exhaled CO2 devices can display false negative results. In comparison, any respiratory function monitor can be used to measure and display gas flow in and out of an endotracheal tube. However, neither method has been examined in detail. We hypothesized that a flow sensor would improve the assessment of tracheal vs esophageal tube placement in neonates with a higher success rate and a shorter time to tube placement confirmation when compared with the use of a quantitative end-tidal CO2 (ETCO2) detector. Between December 2013 and September 2014, preterm and term infants requiring endotracheal intubation were eligible for inclusion and randomly allocated to either ETCO2 ('ETCO2 group') or flow sensor ('flow sensor group'). All infants were analyzed according to their group at randomization (that is, analysis was by intention-to-treat). During the study period, a total of 110 infants (n=55 for each group) were randomized. Successful endotracheal tube placements were correctly identified in 100% of cases by the flow sensor compared with 72% of cases with the ETCO2 detector within 10 in...Continue Reading

References

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Dec 6, 2012·Resuscitation·Georg M SchmölzerCharles Christoph Roehr
Apr 5, 2014·Acta Paediatrica·Sylvia van OsGeorg M Schmölzer

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Citations

Jun 30, 2019·Archives of Disease in Childhood. Fetal and Neonatal Edition·Madeleine C MurphyColm Patrick Finbarr O'Donnell
Nov 7, 2019·Seminars in Fetal & Neonatal Medicine·Deepak Jain, Eduardo Bancalari
Jun 8, 2021·Notfall & Rettungsmedizin·John MadarJonathan P Wyllie

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