POSTSCRIPT
Letter
Neonatal endotracheal intubation: the 7-8-9 rule
| The first 150 words of the full text of this article appear below. |
In ADC Education & Practice Edition, Wylie’s excellent review of neonatal intubation1 deals with many of the practical and physiological issues which continue to challenge staff caring for sick neonates. On the issue of endotracheal tube (ETT) length, I would draw attention to our recently published work which questions the use of the "7-8-9 rule".
This rule suggests that orotracheal tubes should be inserted to a length in cm of (6 plus weight in kg). This would give a tube length of 7 cm for a baby of 1 kg, 8 cm for 2 kg, etc. This relationship was initially derived in the 1970s by Tochen2 in a study of 40 infants. A linear relationship was assumed between tube length and weight, and it was noticeable in Tochen’s paper that eight of the 10 infants under 1000 g had tube lengths below the predicted 50th centile of the
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