Yuri Ozawa1, Anne Ades2,3, Elizabeth E Foglia3, Stephen DeMeo4, James Barry5, Taylor Sawyer6, Neetu Singh7, Kristen Glass8, Philipp Jung9, Bin Huey Quek10, Lindsay Johnston11, Jae Kim12, Natalie Napolitano13, Justine Shults14, Vinay M Nadkarni2,15, Akira Nishisaki2,15. 1. Center for simulation, Advanced Education and Innovation, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. yuri-nishi@hotmail.com. 2. Center for simulation, Advanced Education and Innovation, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. 3. Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. 4. Department of Pediatrics, WakeMed Health and Hospital, Raleigh, Campus NC, USA. 5. Division of Neonatology, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA. 6. Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, WA, USA. 7. Division of Neonatology, Department of Pediatrics, Dartmouth Hitchcock Medical Center, West Lebanon, NH, USA. 8. Division of Neonatology, Department of Pediatrics, Penn State Health Children's Hospital/Penn State College of Medicine, Hershey, PA, USA. 9. Department of Pediatrics, University Hospital Schleswing-Holstein, Campus Luebeck, Luebeck, Germany. 10. Neonatology Department, KK Women's and Children's Hospital, Singapore, Singapore. 11. Division of Neonatology, Yale University School of Medicine, New Haven, CT, USA. 12. Division of Neonatology, Department of Pediatrics, University of California San Diego, San Diego, CA, USA. 13. Respiratory Therapy Department, The Children's Hospital of Philadelphia PA, Philadelphia, PA, USA. 14. Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Pennsylvania, PA, USA. 15. Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Abstract
OBJECTIVE: To determine the impact of premedication for tracheal intubation (TI) on adverse TI associated events, severe oxygen desaturations, and first attempt success STUDY DESIGN: Retrospective cohort study in neonatal intensive care units (NICU) participating in the National Emergency Airway Registry for Neonates from 10/2014 to 6/2017. Premedication for TI was categorized as sedation with neuromuscular blockade, sedation only, or no medication. RESULTS: 2260 TIs were reported from 11 NICUs. Adverse TI associated events occurred less often in sedation with neuromuscular blockade group (10%) as compared to sedation only (29%), or no medication group (23%), p < 0.001. The adjusted odds ratio (aOR) for adverse TI associated events were: sedation with neuromuscular blockade aOR 0.48 (95%CI 0.34-0.65, p < 0.001) compared to no medication. CONCLUSION: Use of sedation with neuromuscular blockade was associated with favorable TI outcomes. This study supports the recommendation for the standard use of sedation with neuromuscular blockade in non-emergency TIs.
OBJECTIVE: To determine the impact of premedication for tracheal intubation (TI) on adverse TI associated events, severe oxygen desaturations, and first attempt success STUDY DESIGN: Retrospective cohort study in neonatal intensive care units (NICU) participating in the National Emergency Airway Registry for Neonates from 10/2014 to 6/2017. Premedication for TI was categorized as sedation with neuromuscular blockade, sedation only, or no medication. RESULTS: 2260 TIs were reported from 11 NICUs. Adverse TI associated events occurred less often in sedation with neuromuscular blockade group (10%) as compared to sedation only (29%), or no medication group (23%), p < 0.001. The adjusted odds ratio (aOR) for adverse TI associated events were: sedation with neuromuscular blockade aOR 0.48 (95%CI 0.34-0.65, p < 0.001) compared to no medication. CONCLUSION: Use of sedation with neuromuscular blockade was associated with favorable TI outcomes. This study supports the recommendation for the standard use of sedation with neuromuscular blockade in non-emergency TIs.
Authors: Megan M Gray; Jennifer A Rumpel; Brianna K Brei; Jeanne Alexandra Krick; Taylor Sawyer; Kristen Glass; Stephen DeMeo; James Barry; Anne Ades; Natalie Napolitano; Lindsay Johnston; Ahmed Moussa; Phillip Jung; Bin Huey Quek; Ayman Abou Mehrem; Jeanne Zenge; Justine Shults; Vinay Nadkarni; Jae Kim; Neetu Singh; Alicia Tisnic; Elizabeth Foglia; Akira Nishisaki Journal: Neonatology Date: 2021-05-04 Impact factor: 4.035
Authors: Lindsay Johnston; Taylor Sawyer; Anne Ades; Ahmed Moussa; Jeanne Zenge; Philipp Jung; Stephen DeMeo; Kristen Glass; Neetu Singh; Alexandra Howlett; Justine Shults; James Barry; Brianna Brei; Elizabeth Foglia; Akira Nishisaki Journal: Neonatology Date: 2021-06-10 Impact factor: 5.106