Indications and outcomes of neonatal intubation: A single-center, prospective study in a middle-income country
1
Issued Date
2022-03-01
Resource Type
ISSN
18759572
Scopus ID
2-s2.0-85117895212
Pubmed ID
34716129
Journal Title
Pediatrics and Neonatology
Volume
63
Issue
2
Start Page
125
End Page
130
Rights Holder(s)
SCOPUS
Bibliographic Citation
Pediatrics and Neonatology Vol.63 No.2 (2022) , 125-130
Suggested Citation
Saisamorn F. Indications and outcomes of neonatal intubation: A single-center, prospective study in a middle-income country. Pediatrics and Neonatology Vol.63 No.2 (2022) , 125-130. 130. doi:10.1016/j.pedneo.2021.09.001 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86102
Title
Indications and outcomes of neonatal intubation: A single-center, prospective study in a middle-income country
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Background: This study assessed the success rate and associated complications of hospital-wide neonatal endotracheal intubations by pediatric residents and neonatal fellows using direct laryngoscopy. Secondary objectives were to identify characteristics and indications for the procedure in a tertiary-care center. Methods: A cross-sectional observational study was conducted. We prospectively collected performance and infant outcome data after neonatal intubation between March 1, 2019 and February 29, 2020. Results: 171 intubations were observed in 105 infants. The median infant gestational age was 31.0 weeks (interquartile range [IQR]: 27.5–36.0 weeks). Fifty infants (48%) were very low birth weight (VLBW, <1500 g; median 1640 g [IQR: 870–2420 g]). The most common indication for intubation was respiratory failure (65%). Pediatric residents and neonatal fellows had overall success rates of 66% and 98%, respectively. The success rate for the first intubation attempt was higher with more advanced pediatric residency training (P < 0.001). The median attempts for each intubation were 1 (IQR: 1–2) for both VLBW and non-VLBW infants (P = 0.48). The adverse outcome rates were 5% and 3% for VLBW and non-VLBW infants, respectively (P = 0.53). More than 2 intubation attempts was the only significant independent risk factor for adverse outcomes (adjusted odds ratio 6.7; 95% CI 1.3–33.6; P = 0.02). Conclusions: The success rate of pediatric residents for neonatal intubation was similar for VLBW and non-VLBW infants. The main indication was respiratory failure, and nearly half were infants with VLBW. To minimize adverse sequelae, written guidelines limiting the number of intubation attempts by junior trainees are warranted.