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 2 ) in tracheal and esophageal gas aspirated using CO 2 detector. Study design Retrospective arm: 20 infants, MIST catheter placement was assessed with a CO 2 detector in two techniques and confirmed with clinical response. Prospective arm—10 infants, aimed to check for CO 2 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 2 detectors can distinguish between tracheal and esophageal placement of MIST catheters prior to MIST.