Respiratory medicine · 2026
Intra-tracheal malposition of endotracheal tubes in newborns: a retrospective single-center study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gardeton Philippe, Reynold De Seresin Magali, Lorton Fleur, Chapoutot Anne-Gaëlle, Joram Nicolas, Flamant Cyril, Bodet Louis-Marie
Аннотация
OBJECTIVE: to describe intra-tracheal tube malposition in newborns and evaluate potential predictors.
DESIGN: retrospective single-center study.
SETTING: French quaternary referral hospital comprising 12 neonatal intensive care unit and 12 pediatric intensive care unit beds.
PATIENTS: term newborns less than 28 days old and preterm newborns under 28 days corrected age, firstly intubated 01/01/2023 - 12/31/2023 irrespective of the intubation site.
MAIN OUTCOME MEASURES: endotracheal tube (ET) distal tip on first chest X-ray after intubation, blindly reviewed by two independent observers, and extensive data regarding intubation and first post-intubation chest X-ray.
RESULTS: one-hundred seventy-eight newborns were included, nearly half premature and half terms (median gestational age at intubation: 36 wk, IQR 28 - 40). Twenty-eight (15.7%) died within hospital discharge. Overall proportion of ET malposition was 63.5% (95% CI 56.4 - 70.6), including 17.4% mainstem intubations. Only weight at intubation was an independent determinant for ET malposition in a multivariate analysis (aOR 10.3; 95% CI 2.06 - 63.7 when intubation's weight was below 1000 g), with a strong trend between weight categories and ET malposition rates. However, ET malposition was not an independent risk factor for death (aOR 1.93; 95% CI 0.65 - 6.54).
CONCLUSIONS: intra-tracheal malposition of endotracheal tubes is extremely frequent in the neonatal population and can be prominently explained by a low weight at intubation implying a short trachea. Clear new strategies are mandatory to determine prior to intubation the ideal endotracheal tube depth marking and to accurately assess the intra-tracheal position of the tube after intubation.
DESIGN: retrospective single-center study.
SETTING: French quaternary referral hospital comprising 12 neonatal intensive care unit and 12 pediatric intensive care unit beds.
PATIENTS: term newborns less than 28 days old and preterm newborns under 28 days corrected age, firstly intubated 01/01/2023 - 12/31/2023 irrespective of the intubation site.
MAIN OUTCOME MEASURES: endotracheal tube (ET) distal tip on first chest X-ray after intubation, blindly reviewed by two independent observers, and extensive data regarding intubation and first post-intubation chest X-ray.
RESULTS: one-hundred seventy-eight newborns were included, nearly half premature and half terms (median gestational age at intubation: 36 wk, IQR 28 - 40). Twenty-eight (15.7%) died within hospital discharge. Overall proportion of ET malposition was 63.5% (95% CI 56.4 - 70.6), including 17.4% mainstem intubations. Only weight at intubation was an independent determinant for ET malposition in a multivariate analysis (aOR 10.3; 95% CI 2.06 - 63.7 when intubation's weight was below 1000 g), with a strong trend between weight categories and ET malposition rates. However, ET malposition was not an independent risk factor for death (aOR 1.93; 95% CI 0.65 - 6.54).
CONCLUSIONS: intra-tracheal malposition of endotracheal tubes is extremely frequent in the neonatal population and can be prominently explained by a low weight at intubation implying a short trachea. Clear new strategies are mandatory to determine prior to intubation the ideal endotracheal tube depth marking and to accurately assess the intra-tracheal position of the tube after intubation.