Well-planned rather than rushed extraction of airway foreign body in 532 g preterm neonate

Abstract A case is presented of an extremely low birth weight (ELBW) and growth restricted preterm twin girl with a birth weight of 532 grams who underwent an airway foreign body extraction via rigid bronchoscopy. The patient was intubated in the delivery room and required administration of surfactant via an access catheter. A chest radiograph on the 5th day of life (DOL) demonstrated a foreign body in the left main bronchus and it was concluded that it had been present for at least 4 days. The foreign body, identified as a 2.8 cm tip of the surfactant catheter accidentally cut upon trimming of the endotracheal tube, was successfully extracted on DOL 6. This case demonstrates the lowest reported weight where such a procedure has been successfully performed without complications. We present a discussion on the optimal timing of foreign body extractions, stressing the importance of pre-operative medical management in improving outcomes.