الفهرس 
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Abstract
E
ndotracheal tube (ETT) malposition is common, especially in very low birth weight infants. Insufficient ventilation, pneumothorax, laryngeal trauma, atelectasis or even death can result from ETT malposition.
To minimize these complications in neonates, the ideal position for the tip of an inserted ETT should be between the upper border of the first thoracic vertebra (T1) and the lower border of the second thoracic vertebra (T2).
We aimed at comparing between the oro-Helical length technique and the 7-8-9 rule in determination of the ideal endotracheal tube insertion depth in neonates.
120 neonates were included at the study. Sixsty of them were intubated according to the OHL method and the other 60 were intubated according to the 7-8-9 method. 12 neonates were excluded from the study.
Neonates included in both study groups were matched with no significant difference regarding gestational age (ranging from 28 to 39 weeks) with mean gestational age of 36 weeks in both study groups, birth weight, sex, maturity, as well as, IUGR. Neonates included in both study groups were matched regarding birth weight groups. Also There was no significant difference between neonates included in both study groups regarding intubation number, O2 saturation before intubation and indication of intubation. There was no significant difference between the OHL method group and 7-8-9 rule group regarding the incidence of ETT malposition (P value > 0.05).also There was no significant difference between preterm and full term neonates regarding the incidence of ETT malposition (P value > 0.05).
The study showed that the incidence of too deep ETT in chest X ray (below T2) was significantly higher in the 7-8-9 rule group than the OHL group (P-value < 0.05) we found also, There was no significant difference between preterm and full term neonates in the proportion of infants with correctly placed ETT tips in both insertion methods.
There was no significant difference between preterm neonates in the OHL method group and 7-8-9 rule group regarding the location of ETT in chest X ray. There was no significant difference between full term neonates in the OHL method group and 7-8-9 rule group regarding the location of ETT in chest X ray. On the other hand there was no significant difference between neonates in OHL method group and 7-8-9 rule group regarding the incidence of pneumothorax, hyperinflation and accidental extubation.
There was no significant difference between neonates in OHL method group and 7-8-9 rule group regarding chest expansion in chest X ray.
There was no significant difference between preterm and full term neonates in OHL group regarding chest expansion in chest X ray. There was no significant difference between preterm and full term neonates in 7-8-9 group regarding chest expansion in chest X ray. Moreover, There was no significant difference between neonates in OHL method group and 7-8-9 rule group regarding duration of mechanical ventilation and mode of ventilation.
The study showed that the median difference between the estimated and the ideal ETT insertion depth was significantly higher in the 7-8-9 group than the OHL groups (P- value = 0.05) and There was positive correlation between OHL and weight and gestational age.
Based on our study, we found that the OHL measurement is a remarkable and very safe alternative method of the ideal ETT depth to the 7-8-9 rule method, especially in small neonates weighing ≤1500 g.