Capnography for catheter location confirmation in minimally invasive surfactant administration.

OBJECTIVES

Minimally Invasive Surfactant Treatment (MIST) is a common method for administering surfactant as a treatment for respiratory distress syndrome. However, tracheal catheter placement can be difficult to confirm. We assessed the presence of carbon dioxide (CO) in tracheal and esophageal gas aspirated using CO detector.

STUDY DESIGN

Retrospective arm: 20 infants, MIST catheter placement was assessed with a CO detector in two techniques and confirmed with clinical response. Prospective arm-10 infants, aimed to check for CO presence in aspirated esophageal gas during routine nasogastric tube insertion.

RESULTS

Retrospective arm: All infants had positive capnography. One infant that had no clinical response to MIST was diagnosed with total anomalous pulmonary venous return. All 10 infants of the prospective arm had a Negative capnography (P < 0.001, Fisher's exact test).

CONCLUSIONS

Readily available CO detectors can distinguish between tracheal and esophageal placement of MIST catheters prior to MIST.