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Use of 2.0-mm endotracheal tubes for periviable infants

Journal of Perinatology volume 42, pages 1275–1276 (2022)Cite this article

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The provision of intensive care for infants born at periviable gestations substantially increased in the past decade. In 2019, more than 500 infants born alive at 22 weeks’ gestation at US hospitals in the Vermont Oxford Network received active treatment (58% of all liveborn infants)—more than twice the number who received intensive care in 2014 [1]. Despite this, appropriately sized equipment for such small patients may not be available at many US hospitals. In a recent survey of US neonatologists, 55% of respondents indicated that their hospitals did not stock 2.0-mm internal diameter endotracheal tubes (ETTs). The authors posited that the inability to use 2.0-mm ETTs may “impact decisions and outcomes” for periviable births [2].

Berger et al. recently described the use of 2.0-mm ETTs to provide initial invasive ventilation to 69 infants born weighing <750 g—one of few reports on 2.0-mm ETTs, and, to our knowledge, the largest to date [3]. The authors reported that 53 (77%) infants initially ventilated with a 2.0-mm ETT survived. They also showed no difference in ventilator days, ETT malfunction, or pCO2 achieved compared to 2.5-mm ETTs. All infants received high-frequency jet ventilation, the first-line ventilation strategy at the University of Iowa during the study period [4].

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References

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Author information

Authors and Affiliations

  1. University of Texas Health Science Center at Houston, Houston, TX, USA

    Matthew Rysavy

  2. Nagano Children’s Hospital, Nagano, Japan

    Tomohiko Nakamura

  3. University of Cologne, Cologne, Germany

    Katrin Mehler, Angela Kribs, André Oberthür & Erik Normann

  4. University of Uppsala, Uppsala, Sweden

    Johan Agren

  5. University of Iowa, Iowa City, IA, USA

    Patrick McNamara, Edward F. Bell, Regan E. Giesinger & Jonathan M. Klein

  6. Nationwide Children’s Hospital, Columbus, OH, USA

    Carl Backes

  7. Kyorin University, Tokyo, Japan

    Satoshi Kusuda

  8. Neonatal Research Network of Japan, Tokyo, Japan

    Satoshi Kusuda

Authors
  1. Matthew Rysavy
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  2. Tomohiko Nakamura
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  3. Katrin Mehler
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  4. Johan Agren
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  5. Patrick McNamara
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  6. Carl Backes
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Consortia

Tiny Baby Collaborative

  • Edward F. Bell
  • , Regan E. Giesinger
  • , Jonathan M. Klein
  • , Angela Kribs
  • , André Oberthür
  • , Erik Normann
  •  & Satoshi Kusuda

Contributions

MR drafted the initial manuscript and subsequent revisions. Data were collected by members of the Tiny Baby Collaborative, including TN, KM, and JA. PM and CB reviewed and revised the manuscript. All authors approved the final version of the manuscript.

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Correspondence to Matthew Rysavy.

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Rysavy, M., Nakamura, T., Mehler, K. et al. Use of 2.0-mm endotracheal tubes for periviable infants. J Perinatol 42, 1275–1276 (2022). https://doi.org/10.1038/s41372-022-01323-7

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  • DOI: https://doi.org/10.1038/s41372-022-01323-7

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