Supplementary Material for: Safely Inserting Neonatal Chest Drains

Background: Inserting a chest drain for a left-sided neonatal pneumothorax carries a risk of penetrating the pericardium. We identified reference ranges for the chest wall thickness (CWT) and distance between the pericardium and parietal pleura to improve safety of chest tube insertion. Method: We prospectively measured the CWT using ultrasound in 20 neonates (body weight [BW] 640–2,700 g, age Results: At both ICSs, curves for the above metrics did not cross, indicating a narrow but safe corridor for each BW with at least 97.5% probability. This safety corridor was 4.6–5.2 mm wide for the 4th and 2.8–3.4 mm for the 5th ICS. Conclusion: These data offer a reference for left-sided chest drain insertion for BW <2,700 g, which may help to improve safety of the procedure.