title: Rigid catheters reduced duration of less invasive surfactant therapy procedures in manikins.
abstract: OBJECTIVE
  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 Magill 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 13-cm and 30-cm 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 Magill forceps. Failure rates (7-20%) were no different between the LIST methods. Techniques using feeding tubes were rated as more difficult.
  
  
  CONCLUSIONS
  Only rigid or stylet-guided catheters required tracheal catheterisation times similar to those of endotracheal intubation and neonatologists found them easier.
authors.affiliation: Neonatology Division, CHU de Liège- CHR Citadelle, Liège, Belgium.
authors.forename: V
authors.identifier: http://orcid.org/0000-0003-1846-7162
authors.initials: V
authors.lastname: Rigo
authors.affiliation: Neonatology Division, UCL St-Luc, Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Debauche
authors.affiliation: Neonatology Division, CHC - St Vincent, Liège, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Maton
authors.affiliation: Neonatology Division, CHU de Liège- CHR Citadelle, Liège, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Broux
authors.affiliation: Neonatology Division, Universitair Ziekenhuis Antwerpen, Antwerp, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Van Laere
mesh_terms: D006801:Humans; D007322:Instillation, Drug; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008348:Manikins; D009359:Neonatology / Q000295:instrumentation* / Q000379:methods*; D011663:Pulmonary Surfactants / Q000008:administration & dosage*
chemical_list: D011663:Pulmonary Surfactants
keywords: Catheters; Less invasive surfactant therapy; Manikin study; Minimally invasive surfactant therapy; Respiratory distress syndrome