Abstract
To compare the clinical endotracheal tube (ETT) depth after initial stabilization of infants with congenital diaphragmatic hernia (CDH) to weight and gestational age-based depth estimates. This retrospective analysis included 58 inborn infants with left-sided CDH. We compared a standard anatomic ETT depth calculated from initial chest radiographs and the clinical depth of the ETT after adjustments to predicted depths using weight and gestational age-based estimates. The standard anatomic depth was deeper than age (1.29 cm ± 1.15 standard deviation, p<0.001) and weight-based (0.59 cm ± 0.95 standard deviation, p<0.001) estimates. The clinical ETT depth was also deeper than age (1.01 cm ± 0.77 standard deviation, p<0.001) and weight-based (0.26 cm ± 0.50 standard deviation, p<0.001) estimates. Established strategies to predict ETT depth underestimate the ideal depth in infants with left-sided CDH. These data suggest utilizing caution during initial ETT placement based on standard depth estimates for patients with CDH.
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