PEDIATRICS Vol. 87 No. 1 January 1991, pp. 44-47
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A New System for Location of Endotracheal Tube in Preterm and Term Neonates

Marc Blayney MB, BCh, MRCPI1, Simon Costello MB, FRACP1, Max Perlman MB, FRCP(C)1, Kel Lui MB, FRACP1, and John Frank MD, FRCP(C)2

1 From the Division of Neonatology (Department of Paediatrics), The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canad
2 From the Department of Preventive Medicine and Biostatistics, University of Toronto, Toronto, Ontario, Canada

A randomized, controlled trial was conducted to evaluate a new noninvasive system for placement of the endotracheal tube, based on a magnetic field interference-sensing technique. Seventy-two neonates treated by the standard technique were compared with 70 treated by the new system (TRACH MATE), with radiographic localization as the standard. As judged by the author(s) on the morning after the intubation, correct initial placement was achieved in 69 (78%) of 88 intubations using the new system, compared with 71 (66%) of 107 using the standard technique (Fisher's Test, one-tailed, P = .044). Repositioning was actually done in 23 (26%) of 88 TRACH MATE intubations, compared with 42 (39%) of 107 standard intubations (Fisher's test, one-tailed; P = .037). Intubation of the right main bronchus occurred in 7 standard intubations, but in none of the TRACH MATE intubations (Fisher's test, one-tailed; P = .014). Endotracheal tube position (high, low, or appropriate) was correctly determined by TRACH MATE in 77 (90%) of 85 intubations; the position was not recorded on three occasions. No differences in the number of complications (eg, unplanned extubations, distal displacement, subglottic stenosis) were found between the two groups. It is concluded that the TRACH MATE technique is superior to the standard clinical method in initial placement of the endotracheal tube.

Key Words: endotracheal tube • neonate

Submitted on December 13, 1989
Accepted on February 20, 1990




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