In current practice, the endotracheal intubation procedure includes the systematic use of the capnometer, which is immediately connected to the tube after its insertion by direct laringoscopy. Confirmation of the correct tube positioning is established by color change of the capnometer from violet to yellow. Then, the colorimetric capnometer is usually removed before connecting the endotracheal tube to the flow-sensor of the ventilator.

For the purpose of our study, after the tube insertion the care provider will connect in line both the capnometer and the ventilator flow-sensor to the tracheal tube.

After performing the tube insertion by direct laryngoscopy, videolaringoscopy or fiberoptic technique, the attending neonatologist will connect both the colorimetric capnometer and the proximal flow-sensor to the tracheal tube. If the flow sensor is not proximal but incorporated into the mechanical ventilator, the care provider will connect the capnometer only. During the procedure, the information given by the capnometer will be evaluated by the care provider performing the intubation, while the flow sensor information will be monitored only by a study investigator, who will not reveal any details to the care provider. In particular, the yellow color change by the capnometer and the presence of exhalation flow curves on the ventilator screen will be considered as confirmation of correct tracheal tube positioning, respectively.

To compare the time (expressed in seconds) taken by the flow sensor and the colorimetric capnometer, respectively, to indicate the correct or not correct positioning of the tube in newborns undergoing tracheal intubation procedure during neonatal intensive care unit admission.

The aim is to evaluate if the flow sensor of the mechanical ventilator can discriminate with similar or faster times the correct positioning of the tube during the tracheal intubation procedure compared to the colorimetric capnometer.

To compare the minimal number of mechanical breaths provided by the ventilator to indicate the correct or not correct positioning of the tube in newborns undergoing tracheal intubation procedure, either evaluating the flow-sensor curves and the color change of the colorimetric capnometer, respectively.

The aim is to evaluate if the flow sensor of the mechanical ventilator can indicate with lower or equal number of mechanical breaths the correct positioning of the tube during tracheal intubation compared to the colorimetric capnometer.