The Effect of Head Position and Angle of Tracheal Bifurcation on Bronchus Catheterization in the Intubated Neonate

Abstract

The effect of head position and angle of tracheal bifurcation on bronchus catheterization was studied in newborn infants. Frequency of bronchus catheterization following appropriate head positioning was evaluated radiographically after passage of a No. 5 French feeding tube in eight intubated neonates within 30 minutes post mortem. Positioning the infants head to the right in preparation for a suctioning procedure may facilitate but not assure catheterization of the left main stem bronchus (LMSB). Positioning the infant's head straight or rotating to the left appears to be equally effective in catheterization of the right main stem bronchus (RMSB). The predominance of RMSB catheterization in infants with their head in the straight position may be explained by the different angles of mainstem bronchi divergence which we determined using radiographs. The angles of divergence of the LMSB and the RMSB from the trachea averaged 44.4 degrees and 24.1 degrees, respectively.