{
  "abstract": "Objective Recommendations on nasal intubation depths in term or preterm newborns are scarce, although this is the preferred route in some countries. Postmenstrual age (PMA) and weight-based recommendations were recently published by our group.Design A prospective quality assurance studySetting Single-centre study (University Children’s Hospital Tübingen)Patients All nasally intubated term and preterm infants between August 2021 and August 2023Interventions Physicians were free to choose the method of orientation for the insertion depth (our recommendations vs other’s (eg, endotracheal tube (ETT) tip markers)). Subsequently, chest X-rays were performed. Correct ETT placement was defined as the tip visible between thoracic vertebrae 1–3. X-ray investigators were blinded to the method of orientation.Main outcome measures Main outcome was the rate of correct ETT placements using our previous recommendation compared with other orientations. Secondary, a subgroup analysis for infants <1000 g and a comparison of PMA-based orientations by European Resuscitation Council (ERC) guidelines were performed.Results 114 intubations/infants were analysed (39 weight-based; 26 PMA-based; 49 others). Median PMA (IQR) was 30 0/7 weeks (26 6/7–35 0/7), weight 1310 g (793–2300). Correct ETT placement was in 74% following our recommendations versus 55% in others (p=0.046). No difference was seen between PMA-based and weight-based recommendations (77 vs 69%; p=0.57). 48 infants <1000 g showed even clearer results; based on ERC guideline, correct placement would have been 27%.Conclusions Our previously published recommendations for nasal intubation depths are applicable in routine care leading to a more accurate ETT placement than with other orientations.",
  "authors": [
    {
      "affiliations": [
        "Department of Neonatology, University Hospital Tübingen, Tübingen, Germany",
        "Center for Pediatric Clinical Studies (CPCS), University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Christian A Maiwald"
    },
    {
      "affiliations": [
        "Department of Neonatology, University Hospital Tübingen, Tübingen, Germany",
        "Department of Pediatrics, Hospital Memmingen, Memmingen, Germany"
      ],
      "name": "Nina Ott"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Frank Fideler"
    },
    {
      "affiliations": [
        "Department of Pediatric Cardiology, Pulmology and Pediatric Intensive Care Medicine, University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Anna C Jock"
    },
    {
      "affiliations": [
        "Division of Pediatric Radiology, Department of Radiology, University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Michael Esser"
    },
    {
      "affiliations": [
        "Division of Pediatric Radiology, Department of Radiology, University Hospital Tübingen, Tübingen, Germany",
        "Department of Pediatrics, Children’s Hospital of Keiskliniken Reutlingen GmbH, Reutlingen, Germany"
      ],
      "name": "Bianca Haase"
    },
    {
      "affiliations": [
        "Department of Neonatology, University Hospital Tübingen, Tübingen, Germany",
        "Center for Pediatric Clinical Studies (CPCS), University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Axel R Franz"
    },
    {
      "affiliations": [
        "Department of Neonatology, University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Christian F Poets"
    },
    {
      "affiliations": [
        "Department of Neonatology, University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Laila Springer"
    }
  ],
  "title": "Prospective evaluation of recommendations for nasal insertion depths in neonatal intubation: a prospective quality assurance study",
  "uid": "3123b560-5f8c-52a5-afa4-ecff4aa9d99a"
}