{Reference Type}: Journal Article
{Title}: Recommendations for endotracheal tube insertion depths in children.
{Author}: Ebenebe CU;Schriever K;Apostolidou S;Wolf M;Herrmann J;Singer D;Deindl P;
{Journal}: Emerg Med J
{Volume}: 40
{Issue}: 8
{Year}: 2023 Aug 19
{Factor}: 3.814
{DOI}: 10.1136/emermed-2022-212494
{Abstract}: <B>BACKGROUND: </B>Endotracheal tube (ETT) malposition is frequent in paediatric intubation. The current recommendations for ETT insertion depths are based on formulae that hold various limitations. This study aimed to develop age-based, weight-based and height-based curve charts and tables for ETT insertion depth recommendations in children.<BR><B>METHODS: </B>In this retrospective single-centre study, we determined the individual optimal ETT insertion depths in paediatric patients by evaluating postintubation radiographic images. Age-based, weight-based and height-based ETT insertion depth recommendations were developed using regression analysis. We compared the insertion depths predicted by the models with previously published formulae.<BR><B>RESULTS: </B>Intubations of 167 children (0-17.9 years) were analysed. Best-fit curves generated with logistic regression analysis revealed R2 values between 0.784 and 0.880. The insertion depths predicted by the models corresponded well with published age-based and height-based formulae. However, they demonstrated the unsuitability of weight-related linear formulae to predict ETT depth in children.<BR><B>CONCLUSIONS: </B>The recommendations developed in this study facilitate a fast and accurate determination of recommended ETT insertion depths in children. Our recommendations provide greater accuracy than previously published formulae and demonstrate that weight-related linear formulae are unsuitable for predicting ETT depth in children.