scholarly journals Partial Obstruction of the Endotracheal Tube by the Plastic Coating Sheared from a Stylet

2016 ◽  
Vol 2016 ◽  
pp. 1-2 ◽  
Author(s):  
Anirudha Das ◽  
Shwetha Chagalamarri ◽  
Kim Saridakis
Keyword(s):  
Endotracheal Tube ◽  
Gestational Age ◽  
Partial Obstruction ◽  
Respiratory Status ◽  
Plastic Particle ◽  
Routine Manner ◽  
Plastic Coating ◽  
Significant Effort

A preterm with gestational age of 24 weeks was intubated at day of life 16. The intubation was done in a routine manner with the use of a stylet. It took a significant effort from the clinician to pull the stylet out after intubation. After intubation the respiratory status of the neonate deteriorated requiring significantly greater support. When ventilating and oxygenating the infant was getting progressively difficult, the decision was made to change the endotracheal tube (ETT). The cause for deterioration of respiratory status was then determined to be a sheared piece of plastic from the sheath of the stylet which was lodged in the lumen of the ETT. After removal of the plastic particle, the condition of the infant improved significantly.

Intraluminal Partial Obstruction of Endotracheal Tube due to Cuff Ballooning

1979 ◽  
Vol 12 (3) ◽  
pp. 312
Author(s):  
Hong Yong Jin ◽  
Kyung Shik Kim ◽  
Chang Keun Ahn
Keyword(s):  
Endotracheal Tube ◽  
Partial Obstruction

The Obstruction of an Endotracheal Tube by the Plastic Coating Sheared from a Stylet

1998 ◽  
Vol 88 (2) ◽  
pp. 548-549 ◽  
Author(s):  
Mukul Bhargava ◽  
Surya N.M. Pothula ◽  
Suhasini Joshi
Keyword(s):  
Endotracheal Tube ◽  
Plastic Coating

Nasal insertion depths for neonatal intubation

2020 ◽  
Vol 105 (6) ◽  
pp. 663-665
Author(s):  
Christian Achim Maiwald ◽  
Patrick Neuberger ◽  
Ingo Mueller-Hansen ◽  
Rangmar Goelz ◽  
Jörg Michel ◽  
...  
Keyword(s):  
Body Weight ◽  
Endotracheal Tube ◽  
Gestational Age ◽  
Thoracic Vertebrae ◽  
Nasal Intubation ◽  
X Rays ◽  
Insertion Depth

AimData on the depth of nasal intubation in neonates are rare, although this is the preferred route in some countries. Therefore, recommendations on optimal nasal intubation depths based on gestational age (GA) and weight are desirable.MethodsWe determined the distances between the middle of thoracic vertebrae 2 (T2) and the tip of the endotracheal tube in 116 X-rays from nasally intubated neonates. The intubation depth (tip to nostril distance) that was documented in the digital patient’s file was then corrected for this distance to reach an optimal nasal insertion depth. Results were plotted against the infant’s GA and weight.ResultsGA-based and birthweight-based charts and formulas for the nasal intubation depth in infants with a GA between 24 and 43 weeks and body weight between 400 and 4500 g were created.ConclusionsGenerated data may help in predicting optimal insertion depths for nasal intubation in neonates.

Is Nasal Septum–Tragus Length Measurement Appropriate for Endotracheal Tube Intubation Depth in Neonates? A Randomized Controlled Study

2019 ◽  
Author(s):  
Özgün Uygur ◽  
Mehmet Yekta Öncel ◽  
Gülsüm Kadıoğlu Şimşek ◽  
Nilüfer Okur ◽  
Kıymet Çelik ◽  
...  
Keyword(s):  
Birth Weight ◽  
Endotracheal Tube ◽  
Gestational Age ◽  
Nasal Septum ◽  
Tube Placement ◽  
Controlled Study ◽  
Proper Place ◽  
Insertion Depth ◽  
Randomized Controlled ◽  
Very High

Abstract Objective Endotracheal intubation is a frequent procedure performed in neonates with respiratory distress. Clinicians use different methods to estimate the intubation insertion depth, but, unfortunately, the improper insertion results are very high. In this study, we aimed to compare the two different methods (Tochen's formula = weight in kilograms + 6 cm; and nasal septum–tragus length [NTL] + 1 cm) used to determine the endotracheal tube (ETT) insertion depth. Study Design Infants who had intubation indications were enrolled in this study. The intubation tube was fixed using the Tochen formula (Tochen group) or the NTL + 1 cm formula (NTL group). After intubation, the chest radiograph was evaluated (above T1, proper place, and below T2). Results A total of 167 infants (22–42 weeks of gestational age) were included in the study. The proper tube placement rate in both groups was similar (32.4 vs. 30.4% for infants < 34 weeks of gestational age and 56.8 vs. 45.0% in infants > 34 weeks of gestational age). The ETT was frequently placed below T2 at a higher rate in infants with a gestational age of <34 weeks, especially in the NTL group (46% in the Tochen group and 60.7% in the NTL group). Conclusion The NTL + 1 cm formula led to a higher rate of ETT placement below T2, especially in infants with a birth weight of <1,500 g. Therefore, more studies are needed to determine the optimal ETT insertion depth.

Perforation and Partial Obstruction of an Armored Endotracheal Tube

1995 ◽  
Vol 7 (2) ◽  
pp. 121-123 ◽  
Author(s):  
Patricia Harrison ◽  
Douglas R. Bacon ◽  
Mark J. Lema
Keyword(s):  
Endotracheal Tube ◽  
Partial Obstruction

Shifting Provider Attitudes and Institutional Resources Surrounding Resuscitation at the Limit of Gestational Viability

2020 ◽  
Author(s):  
Kaitlyn Arbour ◽  
Elizabeth Lindsay ◽  
Naomi Laventhal ◽  
Patrick Myers ◽  
Bree Andrews ◽  
...  
Keyword(s):  
Decision Making ◽  
Endotracheal Tube ◽  
Gestational Age ◽  
The United States ◽  
Delivery Room ◽  
Provider Attitudes ◽  
Comfort Care ◽  
Palliative Care Teams ◽  
Institutional Resources ◽  
Limit Of Viability

Objective This study aimed to provide contemporary data regarding provider perceptions of appropriate care for resuscitation and stabilization of periviable infants and institutional resources available to providers. Study Design A Qualtrics survey was emailed to 672 practicing neonatologists in the United States by use of public databases. Participants were asked about appropriate delivery room care for infants born at 22 to 26 weeks gestational age, factors affecting decision-making, and resources utilized regarding resuscitation. Descriptive statistics were used to analyze the dataset. Results In total, 180 responses were received, and 173 responses analyzed. Regarding preferred course of care based on gestational age, the proportion of respondents endorsing full resuscitation decreased with decreasing gestational age (25 weeks = 99%, 24 = 64%, 23 = 16%, and 22 = 4%). Deference to parental wishes correspondingly increased with decreasing gestational age (25 weeks = 1%, 24 = 35%, 23 = 82%, and 22 = 46%). Provision of comfort care was only endorsed at 22 to 23 weeks (23 weeks = 2%, 22 = 50%). Factors most impacting decision-making at 22 weeks gestational age included: outcomes based on population data (79%), parental wishes (65%), and quality of life measures (63%). Intubation with a 2.5-mm endotracheal tube (84%), surfactant administration in the delivery room (77%), and vascular access (69%) were the most supported therapies for initial stabilization. Availability of institutional resources varied; the most limited were obstetric support for cesarean delivery at the limit of viability (37%), 2.0-mm endotracheal tube (45%), small baby protocols (46%), and a consulting palliative care teams (54%). Conclusion There appears to be discordance in provider attitudes surrounding preferred actions at 23 and 22 weeks. Provider attitudes regarding decision-making at the limit of viability and identified resource limitations are nonuniform. Between-hospital variations in outcomes for periviable infants may be partly attributable to lack of provider consensus and nonuniform resource availability across institutions. Key Points

A Study of the Premature Neonatal Airway

1981 ◽  
Vol 89 (4) ◽  
pp. 604-607 ◽  
Author(s):  
Robert A. Fishman ◽  
Nigel R.T. Pashley
Keyword(s):  
Birth Weight ◽  
Premature Infant ◽  
Endotracheal Tube ◽  
Gestational Age ◽  
Pulmonary Hypoplasia ◽  
Ventilatory Support ◽  
Upper Airway ◽  
Instrument Selection ◽  
Ring Diameter ◽  
Relationship Of

Children born prematurely are now enjoying improved survival with advances in neonatology and ventilatory support. A study of upper airway size in specimens from 39 prematurely born children reveals 7.7% having a cricoid ring diameter greater or equal to the diameter of the tracheal rings. The more commonly expected relationship of the cricoid ring being smaller than the tracheal rings existed in the rest. This may be of importance in instrumentation or intubation of the airway in premature neonates. The gestational age was a better indicator of cricoid ring diameter than birth weight. From these findings a formula for reliably predicting the cricoid diameter is proposed, aiding the clinician in endotracheal tube or airway instrument selection. The combined lung weights were directly related to airway diameter irrespective of measurements of tracheal or cricoid rings. This has not been previously reported and would imply the existence of laryngo-tracheo-broncho-pulmonary hypoplasia in the premature infant.

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