Association of full premedication on tracheal intubation outcomes in the neonatal intensive care unit: an observational cohort study

Objective Evaluate the association of short-term tracheal intubation (TI) outcomes with premedication in the NICU. Study design Observational single-center cohort study comparing TIs with full premedication (opiate analgesia and vagolytic and paralytic), partial premedication , and no premedication...

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Bibliographic Details
Published in:Journal of perinatology 2023-08, Vol.43 (8), p.1007-1014
Main Authors: Neches, Sara K., Brei, Brianna K., Umoren, Rachel, Gray, Megan M., Nishisaki, Akira, Foglia, Elizabeth E., Sawyer, Taylor
Format: Article
Language:English
Subjects:
692/308/409
692/700/1720
Analgesia
Analgesics
Birth weight
Clinical outcomes
Cohort analysis
Heart rate
Intensive care
Intubation
Medicine
Medicine & Public Health
Neonatal care
Neonates
Newborn babies
Observational studies
Pediatric Surgery
Pediatrics
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Summary:Objective Evaluate the association of short-term tracheal intubation (TI) outcomes with premedication in the NICU. Study design Observational single-center cohort study comparing TIs with full premedication (opiate analgesia and vagolytic and paralytic), partial premedication , and no premedication . The primary outcome is adverse TI associated events (TIAEs) in intubations with full premedication compared to those with partial or no premedication. Secondary outcomes included change in heart rate and first attempt TI success. Results 352 encounters in 253 infants (median gestation 28 weeks, birth weight 1100 g) were analyzed. TI with full premedication was associated with fewer TIAEs aOR 0.26 (95%CI 0.1–0.6) compared with no premedication, and higher first attempt success aOR 2.7 (95%CI 1.3–4.5) compared with partial premedication after adjusting for patient and provider characteristics. Conclusion The use of full premedication for neonatal TI, including an opiate, vagolytic, and paralytic, is associated with fewer adverse events compared with no and partial premedication.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-023-01632-5