Abstract
Previous studies in older children have suggested that nasotracheal (NT), as compared to orotracheal (OT), endotracheal tubes remain fixed for longer periods of time without retaping or replacement and have fewer complications. To determine if these findings were valid for neonates, 86 consecutive admissions to the IICU of Children's Hospital of Philadelphia were prospectively studied. All required intubation >48 hrs. Mean birthweights were: OT - 1895±112 gms. SEM; NT - 1903±143 gms. SEM (NS). Mean gestational ages were: OT - 32.1±0.6 wks. SEM; NT - 32.9±0.5 wks. SEM (NS). Mean duration of intubation was similar: OT - 309.8±88.7 hrs. SEM; NT - 322.5±65.4 hrs. SEM (NS). During the period of intubation, there was no difference between frequency of tube retaping (OT-every 60.1±4.3 hrs. SEM; NT-every 64.7±7.7 hrs. SEM) or frequency of tube replacement (OT-every 109.3±9.0 hrs. SEM; NT-every 122.4±12.1 hrs. SEM). The incidence of pneumothorax was 4/43 (9.3%) with OT tubes and 3/43 (7.0%) with NT tubes (NS). Bacterial colonization occurred in 18.6% in the OT group and 39.5% in the NT group, but the difference was not statistically significant. Other problems occurred in 10 infants: 2 could not be nasally intubated; 4 with NT tubes developed nasal erosions; 3 babies with OT tubes developed palatal grooves. This study suggests that NT tubes offer no advantages over OT tubes in the neonatal period, either for stability or frequency of complications.
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Spitzer, A., Fox, W. 1436 A PROSPECTIVE CONTROLLED STUDY OF NASOTRACHEAL VERSUS OROTRACHEAL TUBES IN THE NEONATE. Pediatr Res 15 (Suppl 4), 682 (1981). https://doi.org/10.1203/00006450-198104001-01465
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DOI: https://doi.org/10.1203/00006450-198104001-01465