ArticleFrontiers in medicine2026
Flexible intubating video endoscope-guided determination of optimal oral endotracheal tube depth in infants: a prospective observational study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To assess the accuracy of Advanced Pediatric Life Support (APLS) and Neonatal Resuscitation Program (NRP) formulas for predicting oral endotracheal tube (ETT) depth in Chinese infants undergoing elective surgery, and to develop a flexible intubating video endoscope (FIVE)-verified predictive formula for this population. Methods: In this prospective study, 189 infants (including term neonates and infants aged 1-12 months) who required oral intubation for elective surgery were enrolled. Demographics were recorded, and ETT depths were calculated using APLS and NRP formulas. A reference insertion depth was determined using FIVE, with the tube tip positioned 1 cm above the carina (a pragmatic reference position rather than a universal "ideal"). Correlations between patient characteristics and optimal depth were assessed, and new formulas were developed by linear regression. Results: In neonates, FIVE-confirmed depth correlated with height ( Conclusion: The weight-based APLS formula may be less applicable to Chinese infants undergoing elective surgery. A height-based formula demonstrated closer agreement with the FIVE-referenced depth. Because the model was developed and assessed in the same cohort, it should be considered preliminary and requires independent external validation (preferably multicenter) before widespread clinical use, particularly in non-elective or critically ill populations.
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