Toggle Main Menu Toggle Search

Open Access padlockePrints

Foot length, an accurate predictor of nasotracheal tube length in neonates

Lookup NU author(s): Professor Nicholas EmbletonORCiD, Dr David Milligan


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Background-Existing guidelines for optimal positioning of endotracheal tubes in neonates are based on scanty data and relate to measurements that are either non-linear or poorly reproducible in sick infants. Foot length can be measured simply and rapidly and is related to a number of external body measurements. Objectives-To evaluate the relation of foot length to nasotracheal length in direct measurements at post mortem examinations, and then compare its clinical relevance with traditional weight based estimates in a randomised controlled trial. Methods-The dimensions of the upper airway were measured at autopsy in 39 infants with median (range) postmenstrual age and birth weight of 32 (24-43) weeks and 1630 (640-3530) g. The regression equations with 95% prediction intervals were calculated to estimate the optimal nasotracheal length from foot length. In a randomised trial, 59 neonates were nasally intubated according to foot length and body weight based estimates to assess the achievement of "optimal" and "satisfactory" tube placements. Results-In the direct measurements of the airway at autopsy, foot length was a better predictor of nasotracheal distances (r(2) = 0.79) than body weight, gestational age, and head circumference (r(2) = 0.67, 0.58, and 0.60 respectively). Measurement of foot length was easy and highly reproducible. In the randomised controlled trial, there were no significant differences between the foot length and body weight based estimates in the rates of optimal (44% v 56%) and satisfactory (83% v 72%) endotracheal tube placements. Conclusions-Foot length is a reliable and reproducible predictor of nasotracheal tube length and is at least as accurate as the conventional weight based estimation. This method may be particularly valuable in sick unstable infants.

Publication metadata

Author(s): Embleton ND, Deshpande SA, Scott D, Wright C, Milligan DWA

Publication type: Article

Publication status: Published

Journal: Archives of Disease in Childhood Fetal & Neonatal Edition

Year: 2001

Volume: 85

Issue: 1

Pages: F60-F64

ISSN (print): 1359-2998

ISSN (electronic): 1468-2044

Publisher: BMJ Group