Figure 1 Representation of a new endotracheal tube design. We introduced the new tube into the trachea, and one of its proximally placed colored lines is next to the upper gingiva. We based the distance of insertion on an infant’s weight in kilograms and the color of the line designates the depth of insertion forthe different weights:

► 4 kg infant has a 9.5 cm distance of insertion and the colored line is “ORANGE”,

►3 kg infant has a 8.5 cm distance of insertion and the line is colored“GREEN”

►2 kg infant has a 7.5 cm distance of insertion the line is colored “BLUE”

► 1 kg infants has a distance of insertion of 6.5 cm and the line is colored “RED”.

We measuredthe depth of insertion from the upper gingiva to the tip of the endotracheal tube, and at this distance, the tip of the tube should be located tothe mid-trachea.

Figure 2Relationship between gestational age and the incidence of bronchial intubation in neonates. This figure shows the gestational age at birth (in the weeks after conception) on the “x” axis, and we display the number of subjects that did or did not have bronchial intubation on the “y” axis. The internal legend shows infants in each gestational age category that did have (light-colored fill) or did not have (dark-colored fill) right main stem bronchial intubation. The inverse relationship between advancing gestational age and a reduction in the risk of bronchial intubation is evident.

Table 1: Oro-tracheal Tube Insertion: Lip-to-Tip versus Upper Gingiva- to-Tip Distance

Weight, kg	Mid-Line Depth of Oro-tracheal Tube Insertion
	Centimeters from upper lip­	Centimeters from upper gum line
1	7	6.5
2	8	7.5
3	9	8.5
4	10	9.5

* Textbook of Neonatal Resuscitation (2)

◆ Babies weighing < 750 g require a 6 centimeter depth of insertion from tip-to-lip (2).Caregivers consider this recommendation when inserting an emergency endotracheal tubeinto infants below this weight.

Table 2: Demographic Findings in the Retrospective Study

Gestational Age in Weeks of the Infants­	Number of Intubated Infants
23-26	60
27-29	104
30-33	84
34-36	87
37-42	112
Gender
Male	237
Female	210

* Birth weights ranged from 455 to 4185 grams.

	n	(% of n)	n	(% of n)
23 – 26	2	6	5	16
27 – 29	7	23	8	26
30 – 33	8	26	9	29
34 – 36	3	10	5	16
37-42	11	35	4	13
	31		31
Gender
Male	19	61	18	58
Female	12	39	13	42

Demographics of Infants in the Control Group [Endotracheal Tubes with commercial markings] and the Treatment Group [Endotracheal Tubes with Proximally Placed Colored lines]

* Birth weight ranged from 567 to 4100 grams.