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Catheter insertion depths in less-invasive surfactant administration
  1. Christian Achim Maiwald1,2,
  2. Patrick Neuberger3,
  3. Axel R Franz1,2,
  4. Corinna Engel2,
  5. Jörg Michel4,
  6. Michael Esser5,
  7. Christian F Poets1
  1. 1 Department of Neonatology, University Children's Hospital Tubingen, Tubingen, Baden-Württemberg, Germany
  2. 2 Center for Pediatric Clinical Studies (CPCS), University Children's Hospital Tubingen, Tubingen, Baden-Württemberg, Germany
  3. 3 Department for Neonatology, Klinikum Stuttgart Olgahospital Women's Clinic, Stuttgart, Baden-Württemberg, Germany
  4. 4 Department of Pediatric Cardiology and Intensive Care Medicine, University Children's Hospital Tubingen, Tubingen, Baden-Württemberg, Germany
  5. 5 Division of Paediatric Radiology, Department of Radiology, University Children's Hospital Tubingen, Tubingen, Baden-Württemberg, Germany
  1. Correspondence to Dr Christian Achim Maiwald, Department of Neonatology, University Hospital Tubingen Department of Pediatrics, Tubingen 72076, Germany; Christian.Maiwald{at}med.uni-tuebingen.de

Abstract

Introduction Less-invasive surfactant administration (LISA) under continuous positive airway pressure is increasingly used for the treatment of neonatal respiratory distress. Different procedures are described, but data on the optimal catheter insertion depth are sparse.

Objective To generate data for recommending an optimal catheter insertion depth in LISA.

Methods We examined 112 anterior–posterior chest X-rays from intubated infants and determined the carina’s vertebral projection, whenever possible. After that, distances between the middle of cervical vertebra 4 (C4) and thoracic vertebra 2 and the middle of C4 to thoracic vertebra 3, respectively, were measured. Results were plotted against infant’s weight.

Results A weight-based chart and recommendations for the optimal intratracheal catheter position in infants with a body weight between 350 and 4000 g were created.

Conclusions Generated data offer standardisation and may thus help to find a balance between risk of surfactant reflux and unilateral surfactant administration.

  • neonatology
  • therapeutics

Data availability statement

All data relevant to this data analysis are included in the article or uploaded as supplemental information.

https://doi.org/10.1136/archdischild-2021-321611

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    Data availability statement

    All data relevant to this data analysis are included in the article or uploaded as supplemental information.

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    Footnotes

    • Contributors CAM, AF and CFP were involved in the study design. CAM, JM and ME collected the data. CAM and CE analysed the data. CAM drafted the first version of the manuscript. AF, CFP and PN reviewed the manuscript with respect to clinical interpretation of the data.

    • Funding This research project was supported by a research grant from Lyomark Pharma.

    • Disclaimer The sponsor had no influence on the preparation of data or the contents of this manuscript.

    • Competing interests CAM has a financial relationship in the profits of the Neofact product as inventor and his research projects are partially supported by Lyomark Pharma. The other authors have indicated they have no conflicts of interest relevant to this article to disclose.

    • Provenance and peer review Not commissioned; externally peer reviewed.