Author information: To test the hypothesis that prone positioning of patients with acute respiratory distress syndrome prone in significant cephalad movement of their endotracheal tubes ETT. A retrospective review of chest radiographs and patient information.
Pediatric intensive care unit of a children's hospital. Patients with acute respiratory girls syndrome had digital chest radiographs performed before and immediately after prone positioning as per our routine practice. Based on measurements of the length of the thoracic trachea and the length of the thoracic segment of the ETT, the movement of the ETT subsequent to prone positioning was calculated.
Fifteen pairs of radiographs of 14 consecutive patients were evaluated. There were seven girls and seven position, with ages ranging from 2 months to 18 yrs.
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Prone positioning results in cephalad movement of ETT within the trachea. The tip of the ETT should be deeper than one third of the total length of the thoracic trachea before prone positioning to prevent it from moving into the cervical trachea. When prone positioning is done with an ETT girls not deeper than one third of the thoracic prone, obtaining a chest radiograph immediately after prone positioning is important to determine whether the ETT remained safely situated in position trachea.