Point of care ultrasonography for position of tip of endotracheal tube in neonates

Abstract

Objective: To compare ultrasonography with chest radiograph to detect the level of endotracheal tube tip in intubated neonates.

Design: Observational.

Setting: Neonatal care unit of a teaching hospital.

Participants: 53 neonates selected by convenience sampling.

Intervention: Ultrasonography of chest was done with probe of 5 to 8 MHz using high parasternal view. The distance of the endotracheal tube tip to the arch of aorta on ultrasonography was compared with level of endotracheal tube tip in radiograph.

Primary outcome: Distance of endotracheal tube tip from the upper border of the arch of aorta on ultrasonography.

Results: Endotracheal tube tip was visualised on ultrasonography within 0.5 - 1.0 cm distance from upper border of arch of aorta in 48 out of 53 neonates. This corresponded with the normal position of endotracheal tip in radiograph at T2 to T3. In 5 neonates, endotracheal tube tip was not visualized on ultrasonography and in all these newborns it was at higher level in radiograph.

Conclusions: Distance of endotracheal tip to arch of aorta as measured on ultrasonography is helpful in early identification of the level of endotracheal tube tip.