1. Small for gestation age (SGA) infants are
anatomically and physiologically distinct from appropriate for
gestational age (AGA) infants [2]. However in our study, on
calculating regression equation predicting insertional length (IL,
in cm) from the weight (kg) among AGA and SGA neonates, the results
remained similar (both regression coefficient and intercept) as
follows:
IL (overall population, cm) = wt (kg) +4.95
IL (AGA population, cm) = 1.1×wt (kg) +4.928
IL (SGA population, cm) = 1.1×wt (kg) +4.922
2. We accept that the sample size required in
different groups (calculated post hoc from our results) is
more than the number of infants enrolled. However, there was no
prior study that had reported gestation or weight-based normograms
of optimally placed endotracheal tube on ultrasound to guide us.
Therefore, we conducted a pilot study on 15 infants in two weight
categories. To derive adequate sample size in five weight categories
and four gestation categories, a pilot study would require about
80-100 infants, which was not feasible for us.
3. Median (IQR) day of enrollment of the neonates
was 3 (1-9) days. None of the study subjects had cephalhematoma or
subgaleal bleed. Neonates with caput succedaneum enrolled on day 1
had their head circumference measurement repeated after 48 hours of
life, not only for our study but also as a standard clinical
protocol because resolution of caput succedaneum takes few days [3].
We agree that our study had male preponderance and the possibility
of calculating sex-specific normative data of optimally placed
endotracheal tube on ultrasound based on adequate sample size needs
to be explored.