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Intubation Attempts Increase the Risk for Severe Intraventricular Hemorrhage in Preterm Infants-A Retrospective
Charles W Sauer1, Juin Yee Kong2, Yvonne E Vaucher1
1Department of Pediatrics, University of California, San Diego, CA.
Insights
Multiple intubation attempts in neonates increase the risk of severe intraventricular hemorrhage (IVH), particularly in premature infants. Further research is needed to confirm this association.
Area of Science:
- Neonatal care
- Pediatric neurology
- Critical care medicine
Background:
- Intraventricular hemorrhage (IVH) is a significant concern in premature infants.
- Multiple intubation attempts are common in the neonatal intensive care unit (NICU).
- The relationship between repeated intubation attempts and IVH severity requires further investigation.
Purpose of the Study:
- To determine if neonates undergoing multiple intubation attempts within the first four days of life have a higher incidence of IVH.
- To analyze this association in different birth weight subgroups.
Main Methods:
- Retrospective cohort study design.
- Inclusion of infants with birth weights (BW) <1500 g admitted to a NICU.
- Subgroup analysis for infants with BW <750 g.
Main Results:
- A total of 308 infants (BW <1500 g) and 102 infants (BW <750 g) were included.
- Increased intubation attempts correlated with severe IVH in infants with BW <750 g (OR 1.395).
- For infants with BW <1500 g, more delivery room intubation attempts were linked to severe IVH (OR 1.317).
Conclusions:
- Elevated intubation attempts are associated with increased severe IVH incidence in specific low birth weight neonate groups.
- This association was noted in infants <750 g and <1500 g intubated in the delivery room.
- Prospective studies are recommended to validate these findings.
Objective:
To evaluate whether neonates exposed to multiple intubation attempts within the first 4 days after birth have an increased incidence of intraventricular hemorrhage (IVH).
Study Design:
This is a retrospective cohort study of infants intubated during the first 4 days after birth. Infants had birth weights (BWs) less than 1500 g and were admitted to the neonatal intensive care unit (NICU) at the University of California, San Diego, between January 1, 2005, and July 30, 2009. A subgroup analysis was done for infants with BW less than 750 g.
Results:
A total of 308 infants with BW <1500 g, including 102 with a BW <750 g, were intubated within the first 4 days of life. The number of intubation attempts was significantly greater in infants with a BW <750 g who had severe IVH compared with those with mild or no IVH (OR 1.395, 95% CI 1.090-1.786, P = .008). For infants with BW <1500 g, the number of intubation attempts in the delivery room was significantly greater for infants with severe IVH (OR 1.317, 95% CI 1.052-1.649, P = .016).
Conclusion:
Increased intubation attempts were associated with increased incidence of severe IVH in infants with BW less than 750 g and in infants less than 1500 g who were intubated only in the delivery room. Prospective studies are needed to further evaluate the relationship between intubation attempts and severe IVH.
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