1146 Use of Exhaled Co2 Detector for Neonatal Intubation

Background: Endotracheal intubation is a common procedure performed in NICU. Sometimes, it is difficult to confirm the successful intubation using standard methods like auscultation. Exhaled CO2 detectors have been widely used in paediatric and adult population and sparingly in neonates. It has been felt that it is an effective confirmation technique for successful intubations. Aim: To determine whether use of exhaled CO2 detector during neonatal intubation reduces number of attempts during neonatal intubation and increases the certainty about successful intubation. Method: Data were collected for each intubation on a pre-designed proforma at tertiary neonatal unit for three months before (Group A) and after introduction of exhaled CO2 detector (Group B). Data were obtained as part of an audit so ethical approval was not required. Results: Thirty seven intubations were performed in Group A (8 excluded-data inadequate) and twenty five in Group B. There were no statistically significant differences between two groups as far as numbers of attempts are concerned. Certainty of successful intubation increased significantly with the use of exhaled CO2 detector, Group A 22/29 versus Group B 24/25, p value 0.02. We also noted that haemodynamic parameters were similar in both the groups. Conclusion: Using an exhaled CO2 detector reduces uncertainty about endotracheal tube placement but does not reduces number of attempts at intubation.