Techniques to ascertain correct endotracheal tube placement in neonates

• Published in: Cochrane database of systematic reviews 2018-07, Vol.2018 (7)
• Main Authors: Schmölzer, Georg M, Roehr, Charles Christoph C
• Format: Article
• Language: English
• Subjects: Medicine General & Introductory Medical Sciences
• ISSN: 1469-493X
• DOI: 10.1002/14651858.CD010221.pub3

When a newborn baby requires a tube to be inserted into the windpipe to help him/her breathe, the clinical team can take a radiograph (X‐ray) to confirm that the tube is correctly positioned. Because this is often delayed, however, newer techniques aimed at rapidly confirming the correct placement of the breathing tube within the windpipe have been developed. The rapid confirmation of correct tube placement is important because a wrongly placed tube can result in serious adverse outcomes, including death, low levels of oxygen in the blood, an abnormal collection of air or gas between the lung and the chest wall, which can interfere with breathing, or the collapse of the lung. New techniques for the rapid determination of tube placement include the use of clinical signs, the measurement of air going in and out of the lung (using a respiratory function monitor), measuring the amount of exhaled carbon dioxide (CO 2 ) and using ultrasound to image the tube within the windpipe. The aim of this study was to compare chest X‐ray with any of these new techniques for determining the correct placement of the breathing tube in newborn infants, in either the delivery room or the intensive care unit, and to determine subsequent mortality and morbidity in newborn infants who have been intubated. However, we were unable to identify any studies that met our inclusion criteria.