INTRODUCTION: Securing the uncuffed endotracheal tubes of infants requiring mechanical ventilation is imperative to avoid the complications that often accompany unplanned extubation. We evaluated the effect of two methods of securing the endotracheal tube on the incidence of spontaneous extubation. MATERIALS & METHOD: We prospectively studied the incidence of accidental extubation in 244 infants, meeting predetermined criteria, who were admitted to our Level-2 neonatal intensive care unit. Oral endotracheal tubes were secured by conventional taping or by an oral fixation device (the Logan Bow, ie, nuchal arch). The device was applied depending on availability. RESULTS: Fewer patients were accidentally extubated with the Logan Bow (21.3% vs 58.7%, p < 0.0001) and there were fewer extubations/100 ventilator days (2.1 vs 3.0). When stratified by weight, the difference in extubation weights was significant only for patients weighing ≤ 1.5 kg. CONCLUSION: The use of the Logan Bow to secure uncuffed endotracheal tubes may reduce the unplanned extubation rate of mechanically ventilated low birthweight infants.
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