Home
|
Inbox
|
Search
|
View Abstract
Evaluating the Practice of Repositioning Endotracheal Tubes in Neonates and Children Based on Radiographic Location
Description
.abstract img { width:300px !important; height:auto; display:block; text-align:center; margin-top:10px } .abstract { overflow-x:scroll } .abstract table { width:100%; display:block; border:hidden; border-collapse: collapse; margin-top:10px } .abstract td, th { border-top: 1px solid #ddd; padding: 4px 8px; } .abstract tbody tr:nth-child(even) td { background-color: #efefef; } .abstract a { overflow-wrap: break-word; word-wrap: break-word; }
A6810 - Evaluating the Practice of Repositioning Endotracheal Tubes in Neonates and Children Based on Radiographic Location
Author Block: D. D. Im, P. A. Ross, J. Hotz, C. J. Newth; Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, United States.
Rationale: Chest radiographs (CXR) are commonly performed in the pediatric intensive care unit setting to confirm the position of the endotracheal tube (ETT). The radiographic location of the ETT tip is then often evaluated to determine if it is an adequate position in relation to the carina. The purpose of this study was to evaluate the practice and accuracy of adjusting endotracheal tubes in the neonatal and pediatric population.
Methods: Single-institution retrospective study. The electronic medical record was queried to identify all patients in the pediatric intensive care unit and cardiothoracic intensive care unit who received an ETT repositioning from September 2016 to September 2017. CXR before and after ETT repositioning were examined to measure the distance from tip of the ETT to the carina. Descriptive statistical analysis was used to report the results. Results: Patient ages ranged from 1 day old to 16 years of age. 40 percent of ETT repositioning interventions were followed by another ETT repositioning within 72 hours. 59 percent of those re-interventions were in the opposite direction of the original desired ETT repositioning. ETT repositioning by 0.5 cm resulted in a post-repositioning radiographic location 160 percent different than the desired intervention. ETT repositioning by 1.0 cm was associated with a 67 percent difference. Greater than 1.0 cm changes were associated with an 81 percent difference. In neonates (less than 30 days of age) receiving ETT repositioning, a 116 percent difference from the desired intervention was observed, compared to 85 percent differences seen in ETT repositioning in patients older than 1 month of age. Conclusions: Adjusting the ETT based on radiographic location is an inaccurate process, as evidenced by the re-interventions that are often required to get the ETT in a satisfactory position. Inaccuracies are seen particularly with smaller movements and in younger patients. Repositioning the ETT by 0.5 cm and in the neonatal age group leads to the most inaccuracy in post-repositioning radiographic location from the desired change. This study highlights important points that should be considered by the physician when making a decision to adjust the ETT based on radiographic location.
Author Block: D. D. Im, P. A. Ross, J. Hotz, C. J. Newth; Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, United States.
Rationale: Chest radiographs (CXR) are commonly performed in the pediatric intensive care unit setting to confirm the position of the endotracheal tube (ETT). The radiographic location of the ETT tip is then often evaluated to determine if it is an adequate position in relation to the carina. The purpose of this study was to evaluate the practice and accuracy of adjusting endotracheal tubes in the neonatal and pediatric population.
Methods: Single-institution retrospective study. The electronic medical record was queried to identify all patients in the pediatric intensive care unit and cardiothoracic intensive care unit who received an ETT repositioning from September 2016 to September 2017. CXR before and after ETT repositioning were examined to measure the distance from tip of the ETT to the carina. Descriptive statistical analysis was used to report the results. Results: Patient ages ranged from 1 day old to 16 years of age. 40 percent of ETT repositioning interventions were followed by another ETT repositioning within 72 hours. 59 percent of those re-interventions were in the opposite direction of the original desired ETT repositioning. ETT repositioning by 0.5 cm resulted in a post-repositioning radiographic location 160 percent different than the desired intervention. ETT repositioning by 1.0 cm was associated with a 67 percent difference. Greater than 1.0 cm changes were associated with an 81 percent difference. In neonates (less than 30 days of age) receiving ETT repositioning, a 116 percent difference from the desired intervention was observed, compared to 85 percent differences seen in ETT repositioning in patients older than 1 month of age. Conclusions: Adjusting the ETT based on radiographic location is an inaccurate process, as evidenced by the re-interventions that are often required to get the ETT in a satisfactory position. Inaccuracies are seen particularly with smaller movements and in younger patients. Repositioning the ETT by 0.5 cm and in the neonatal age group leads to the most inaccuracy in post-repositioning radiographic location from the desired change. This study highlights important points that should be considered by the physician when making a decision to adjust the ETT based on radiographic location.
|
Home
|
Inbox
|
Search
|