Endotracheal intubation of a preterm infant cadaver was performed both orally and nasally to assess the relative movement of the endotracheal tube with changes in head position. For each method of intubation, anteroposterior radiographs were obtained with the head in neutral, flexed, extended, and laterally rotated positions. The results indicate slightly increased movement of the nasotracheal tube with flexion and rotation, and markedly increased movement with extension. The possible relationship between tube movement and the development of subglottic stenosis is discussed.
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References
1.
DukePMCoulsonJDSantosJIJohnsonJD. Cleft palate associated with prolonged orotracheal intubation in infancy. J Pediatr1976; 89: 990–1.
2.
SaundersBSEasaDSlaughterRJ. Acquired palatal groove in neonates. A report of two cases. J Pediatr1976; 89: 988–9.
3.
ThibeaultDWGregoryGA. Neonatal pulmonary care. Addison-Wesley: Menlo Park, Calif, 1979.
4.
JungALThomasGK. Stricture of the nasal vestibule: A complication of nasotracheal intubation in newborn infants. J Pediatr1974; 85: 412–4.
5.
BerryFAJrBlackenbakerWLBallCG. A comparison of bacteremia occurring with nasotracheal and orotracheal intubation. Anaes Anal1973; 52: 873–6.
6.
SchildJPWuilloudAKollbergHBossiE. Tracheal perforation as a complication of nasotracheal intubation in a neonate. J Pediatr1976; 88: 631–2.
7.
MarshakGGrundfastKM. Subglottic stenosis. Pediatr Clin North Am1981; 28: 941–8.
8.
TodresIDdeBrosFKramerSSMoylanFMBShannonDC. Endotracheal tube displacement in the newborn infant. J Pediatr1976; 89: 126–7.
9.
DonnSMKuhnsLR. Mechanism of endotracheal tube movement with change of head position in the neonate. Pediatr Radiol1980; 9: 37–40.
10.
SpitzerARFoxWW. Postextubation atelectasis — The role of oral versus nasal endotracheal tubes. J Pediatr1982; 100: 806–10.
