Anatomical tracheal parameters in premature neonates with birth body weight less than 1000 g for effective and safe administration of surfactant

Abstract

Objective. To evaluate anatomical tracheal parameters of fetus and premature infant for clarifying the permissible and safe depth of insertion and «thin catheter» diameter during minimally invasive administration of surfactant.Material and methods. Autopsy examination of fetuses and newborns with extremely low birth weight, who died during their first 168 hours of life. The study describes only 26 cases, respiratory system malformations are excluded. The authors measured the distance from the glottis to the bifurcation, the perimeter of the trachea under the ligaments, in the middle part and at the level of the bifurcation with the calculation of the trachea diameter.Results. The average body weight was 684.6 ± 160.8 g, gestational age varied from 21 to 33 weeks and averaged 25 weeks. The distance from the glottis to the bifurcation was 34.31 ± 5.28 mm, and the diameter in the upper, middle and lower thirds was 3.53 ± 0.64 mm, 3.41 ± 0.63 and 3.69 ± 0.78 mm respectivelyApplication of the results: registration of these indicators when choosing a catheter for minimally invasive administration of a surfactant and the depth of its introduction into the trachea in newborns with extremely low body weight will help to avoid such complications, as one-lung administration of surfactant and its regurgitation from the trachea during the procedure, thereby increasing the efficiency and safety of the methodConclusion. The length and diameter of trachea in neonates with extremely low birth weight in the early neonatal period depend on anthropometric values and gestational age at birth, mean length is 34.31±5.28 mm.