Abstract :
[en] Aim: Different catheters can be used for less invasive surfactant therapy (LIST): feeding tubes inserted with or without Magill forceps, different angiocatheters and centre specific devices, such as umbilical catheters affixed to a stylet. This study compared the effectiveness of LIST devices and endotracheal tubes (ETT).
Methods: Video recordings of 20 neonatologists simulating different LIST techniques on two manikin heads were analysed. Procedural effectiveness was evaluated by the duration of procedures and failure rates. Ease of use was scored.
Results: The median procedure time for the Neonatal Intubation Trainer was significantly longer with feeding tubes without Maggil forceps. For the more difficult ALS Baby Trainer, successful procedures lasted a median of 24 (17-32) seconds with ETT, 24 (15-36) seconds with stylet-guided catheters and 34 (27-46) seconds and 37 (29-42) seconds with 13cm and 30cm angiocatheters, respectively. Both methods using feeding tubes were statistically slower than ETT intubation, lasting 32 (25-44) seconds and 39 (27-95) seconds with or without Maggil forceps. Failure rates (7-20%) were no different between the LIST methods. Techniques using feeding tubes were rated as more difficult.
Conclusion: Only rigid or stylet-guided catheters required tracheal catheterisation times similar to those of endotracheal intubation and neonatologists found them easier.
KEY NOTES
• This manikin study used video recordings of 20 neonatologists to compare the effectiveness of devices for less invasive surfactant therapy (LIST) and endotracheal tubes.
• The durations of tracheal catheterisation for LIST using rigid or stylet-guided catheters were no different from those obtained with endotracheal tubes, but feeding tubes with or without Maggil forceps required longer procedures.
• Neonatologists found rigid or stylet-guided catheters easier to use.
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