Comparison of Nasal Tragus Length and Formula For Correctness of Endotracheal Tube Placement in Neonates

Objective: To compare the nasal tragus length and weight+6 cm formula for correctness of endotracheal tube placement in neonates. Study Design: Comparative Prospective Study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jul 2019 to Apr 2020. Methodology: A prospective study was conducted on the neonates requiring endotracheal intubation in the neonatal intensive care unit. Patients were randomly divided into two groups via lottery method. In Group A nasal tragus length +1cm was used to estimate the length of intubation while in group B weight+6 cm formula was used for the same purpose. Correct placement of the endotracheal tube was ascertained by the chest x-ray in both the groups. Results: A total of 300 patients were included into the final analysis. Out of them 249(83%) had correct placement of tube while 51(17%) had incorrect placement on chest x-ray. 167(55.7%) underwent endotracheal intubation with formula of weight+6 cm while 133(44.3%) underwent with nasal tragus length+1 cm. Chi-square analysis revealed that nasal tragus length has statistically significant relationship with correct placement of the endotracheal tube among the neonates managed at nursing intensive care unit (p-value<0.05). Conclusion: Considerable number of neonates had incorrect placement of endotracheal tube in our study on chest x-ray. Nasal tragus length +1 cm emerged as a better method for correct placement of endotracheal tube in our target population as compared to weight +6 cm formula used for the same purpose.