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Objective <p>Develop a birth anthropometry-based model to estimate initial endotracheal tube (ETT) insertion depth for infants with birth weight &lt;500 g.</p> Study design <p>Retrospective single center cohort (2010–2025) including infants with birth weight &lt;500 g, intubated on day 0 and underwent a postintubation chest radiograph. Adequate depth was defined as lip-to-tip placement between the upper border of T1 and the lower border of T2. Linear and quadratic models using birth weight and length were compared; the final model was presented as a bedside nomogram.</p> Result <p>Eighty-two infants met the inclusion criteria. Birth weight and length independently predicted radiograph-derived optimal depth (<i>p</i> &lt; 0.001). A combined quadratic model showed the strongest fit (adjusted <i>R</i>² = 0.70), outperforming single parameter rules.</p> Conclusion <p>In neonates &lt;500 g, a quadratic weight-length model improves the prediction of radiograph-defined midtracheal ETT depth and offers a practical bedside guide for initial placement.</p>

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Optimal endotracheal tube insertion depth in infants with birth weights under 500 grams

  • 期刊论文

  • 发表日期：

    2026年3月30日

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  • Kyusang Yoo,
  • Soo Hyun Kim,
  • Jung Il Kwak,
  • Tae-Gyeong Kim,
  • Abraham Kwak,
  • Juhee Park,
  • Joo Hyung Roh,
  • Jeong Min Lee,
  • Ha Na Lee,
  • Jiyoon Jeong,
  • Chae Young Kim,
  • Euiseok Jung,
  • Byong Sop Lee

摘要

Objective

Develop a birth anthropometry-based model to estimate initial endotracheal tube (ETT) insertion depth for infants with birth weight <500 g.

Study design

Retrospective single center cohort (2010–2025) including infants with birth weight <500 g, intubated on day 0 and underwent a postintubation chest radiograph. Adequate depth was defined as lip-to-tip placement between the upper border of T1 and the lower border of T2. Linear and quadratic models using birth weight and length were compared; the final model was presented as a bedside nomogram.

Result

Eighty-two infants met the inclusion criteria. Birth weight and length independently predicted radiograph-derived optimal depth (p < 0.001). A combined quadratic model showed the strongest fit (adjusted R² = 0.70), outperforming single parameter rules.

Conclusion

In neonates <500 g, a quadratic weight-length model improves the prediction of radiograph-defined midtracheal ETT depth and offers a practical bedside guide for initial placement.