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A comparison of two methods of oral endotracheal tube stabilization in neonatal patients.

OBJECTIVE
To determine if an endotracheal tube stabilization method using an umbilical clamp reduces accidental extubations when compared with a more traditional method of endotracheal tube stabilization.


STUDY DESIGN
From January 1, 1994 through April 30, 1997, the frequency of accidental extubations per 100 ventilator days was tracked for the Neonatal Intensive Care Unit (NICU) Quality Assurance Committee of William Beaumont Hospital (Royal Oak, MI). From January 1, 1994 through December 31, 1995, all endotracheal tubes were stabilized using a traditional taping method. From March 1, 1996 through April 30, 1997, the endotracheal tubes were stabilized using a modified umbilical clamp and tape. The incidence of extubation using each stabilization method was compared by chi2 analysis.


RESULTS
The umbilical clamp resulted in a significantly lower (p=0.001) rate of accidental extubations.


CONCLUSION
The umbilical clamp taping method appears to have lowered the incidence of accidental extubation in our NICU when compared with a standard method of oral endotracheal tube stabilization.