Determine the Appropriate Size of the Endotracheal Tube by Method Air Leak Test in Infants Weighing Less Than 2500 Grams and Compare It with Common Standards

Endotracheal intubation is common in premature infants due to the need for respiratory support. Therefore, choosing the right size of endotracheal tube to prevent damage and minimize air leakage seems necessary. The aim of this study was to determine the appropriate size of endotracheal tube in infants weighing less than 2500 grams (g) and compare it with common standards.

This is a cross-sectional descriptive-analytical study, which was performed on infants weighing less than 2500 g; undergone endotracheal intubation in Tabriz Children's Hospital in 2016. The infants were divided into different weight groups (2000 to 2500 g,1500 to 2000 g,1000 to 1500 g and under 1000 g). First, they were intubated by using the suggested size, based on weight. Then an air leak test is performed and if the test is positive, a larger endotracheal tube size has been tested to reach the appropriate size. This obtained size was compared with the proposed size based on existing standards.

Needing for re-intubation was high among all infants and most of them needed re-intubation at least once. In the weight group 1500 to 2500 g, the initial size of 3.5 for the endotracheal tube seems to be optimal (as opposed to the suggested size 3). In the weight group less than 1500 g, size 3 endotracheal tube was the most frequently used tube (as opposed to the recommended sizes 2 and 2.5).

The results of this study show that using the recommended endotracheal tube size for infants is erroneous and most infants are intubated with at least one larger endotracheal tube size due to the positive air leakage test.