Indications for endotracheal intubation

The purpose of the study was to propose recommendations for endotracheal intubation and respiratory support in newborn and in infants. The recommendations for endotracheal intubation are preceeded by a short history of intubation, basic anatomy of the upper airway in infants and children and the most common methods of airway control. The main indications for intubation are airway protection and control of the airway. Such circumstances may be: general anaesthesia, congenital malformations and diseases of the upper airway, mechanical ventilation, perinatal resuscitation and various forms of acute respiratory distress. Endotracheal intubation is strongly recommended during general anaesthesia in infants, complete and almost complete obstruction of the upper airway (grade A). Intubation is also necessary when bag-mask ventilation is ineffective, and when external chest compressions are being delivered. The position of the tube must be confirmed by a capnometer or a disposable CO(2) sensor (Class A, LOE 1a and 1b). Endotracheal intubation and mechanical ventilation should be considered in cases of frequent, caffeine and nCPAP-resistant apnoeic episodes, in the ARDS and progressive ventilatory failure in sepsis. (Class B).