RESUMO
OBJECTIVE: To develop a bedside equation that can be used to estimate the ideal oral and nasal endotracheal tube (ETT) length for children younger than 1 year of age. STUDY DESIGN: Retrospective database analysis of 735 children younger than 1 year of age admitted to pediatric intensive care at Evelina London Children's Hospital from June 1, 2019, through August 31, 2021. ETT positions were determined by tube-tip superimposition over vertebral body on postintubation chest radiograph by trained medical students and pediatric radiologists with bedside assessment of ETT length at nostril or lip as recorded electronically by nursing staff. RESULTS: The position of 1176 ETTs were evaluated, of which 784 (66%) were nasal and 392 (33%) were oral. After averaging length to account for multiple intubation events per patient, 281 (39%) nasal tubes and 105 (28%) oral tubes were found to be positioned optimally at T2. Using weight was superior to age or corrected age at estimating ETT length. Regression analysis revealed that optimal (T2) positioning of oral ETTs occurs at a length of (weight2+8) cm and in nasal ETTs at (weight2+9.5) cm with a mean absolute prediction error of 5%. The formulae did not require adjustments for those with comorbidities or prematurity. CONCLUSIONS: The optimal insertion length of ETTs placed both orally and nasally in children up to 1 year of age can be estimated with appropriate accuracy by a simple bedside formula using weight as the only variable.
