Factors that impact second attempt success for neonatal intubation following first attempt failure: a report from the National Emergency Airway Registry for Neonates.
Arch Dis Child Fetal Neonatal Ed
; 2024 Feb 28.
Article
em En
| MEDLINE
| ID: mdl-38418208
ABSTRACT
OBJECTIVE:
To determine the factors associated with second attempt success and the risk of adverse events following a failed first attempt at neonatal tracheal intubation.DESIGN:
Retrospective analysis of prospectively collected data on intubations performed in the neonatal intensive care unit (NICU) and delivery room from the National Emergency Airway Registry for Neonates (NEAR4NEOS).SETTING:
Eighteen academic NICUs in NEAR4NEOS. PATIENTS Neonates requiring two or more attempts at intubation between October 2014 and December 2021. MAIN OUTCOMEMEASURES:
The primary outcome was successful intubation on the second attempt, with severe tracheal intubation-associated events (TIAEs) or severe desaturation (≥20% decline in oxygen saturation) being secondary outcomes. Multivariate regression examined the associations between these outcomes and patient characteristics and changes in intubation practice.RESULTS:
5805 of 13 126 (44%) encounters required two or more intubation attempts, with 3156 (54%) successful on the second attempt. Second attempt success was more likely with changes in any of the following intubator (OR 1.80, 95% CI 1.56 to 2.07), stylet use (OR 1.65, 95% CI 1.36 to 2.01) or endotracheal tube (ETT) size (OR 2.11, 95% CI 1.74 to 2.56). Changes in stylet use were associated with a reduced chance of severe desaturation (OR 0.74, 95% CI 0.61 to 0.90), but changes in intubator, laryngoscope type or ETT size were not; no changes in intubator or equipment were associated with severe TIAEs.CONCLUSIONS:
Successful neonatal intubation on a second attempt was more likely with a change in intubator, stylet use or ETT size.
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1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article