Assessment of techniques to ascertain correct endotracheal tube placement in neonates

  • Protocol
  • Intervention



This is the protocol for a review and there is no abstract. The objectives are as follows:

To compare two-view chest radiogram (control) versus various techniques (intervention) for identification of correct tube placement after oral or nasal intubation in newborn infants in either the delivery room or neonatal intensive care unit.

  • Two-view chest radiogram (control) versus clinical assessment (intervention).

  • Two-view chest radiogram (control) versus exhaled CO2 (intervention).

  • Two-view chest radiogram (control) versus respiratory function monitoring (intervention).

Subgroup analysis will be performed to determine whether the safety and efficacy vary according to:

  • postmenstrual age: Term (37 weeks’ postmenstrual age and above) versus preterm between 29 and 36 weeks versus preterm < 29 weeks infants;

  • type of clinical assessment (heart rate versus adequate chest wall movements versus confirmation of position by direct laryngoscopy versus observation of ETT passage through the vocal cords versus presence of breath sounds in the axilla and absence of breath sounds in the epigastrium versus condensation in the ETT during ventilation);

  • type of exhaled CO2 monitoring (semi-quantitative colorimetric versus main stream versus side stream versus micro stream CO2-detectors);

  • type of respiratory function monitor;

  • skill level of operator (< 1 year; 2 to 5 years; > 5 to 10 years; > 10 years);

  • discipline of operator (Medical, Nursing, Respiratory Therapist).