Digital palpation of endotracheal tube tip as a method of confirming endotracheal tube position in neonates: an open‐label, three‐armed randomized controlled trial

SummaryObjectiveTo compare the malposition rates of endotracheal tubes (ETTs) when the insertional length (IL) is determined by a weight‐based nomogram versus when IL is determined by palpation of the ETT tip.DesignOpen‐label, randomized controlled trial (RCT).SettingLevel III neonatal intensive care unit (NICU).SubjectsAll newborn babies admitted in NICU requiring intubation.InterventionsSubjects were randomly allocated to one of three groups, wherein IL was determined by (i) weight‐based nomogram alone, (ii) weight‐based nomogram combined with suprasternal palpation of ETT tip performed by specially trained neonatology fellows, or (iii) combination of weight‐based and suprasternal methods by personnel not specially trained.Primary OutcomeRate of malposition of ETT as judged on chest X‐ray (CXR).ResultsFifty seven babies were randomized into group 1(n = 15), group 2 (n = 20), and group 3 (n = 22). The proportion of correct ETT placement was highest in group 2, being 66.7%, 83.3%, and 66.7% in groups 1 through 3, respectively (P value = 0.58). No complication was attributable to palpation technique.ConclusionSuprasternal palpation shows promise as a simple, safe, and teachable method of confirming ETT position in neonates.

Digital palpation of endotracheal tube tip as a method of confirming endotracheal tube position in neonates: an open‐label, three‐armed randomized controlled trial Journal Articles