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Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications
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Association of multiple tracheal intubation attempts with clinical outcomes in extremely preterm infants: a

Kathleen E Miller1, Neetu Singh2

  • 1Geisel School of Medicine at Dartmouth, Hanover, NH, USA. kathleen.elizabeth.miller@gmail.com.

Journal of Perinatology : Official Journal of the California Perinatal Association
|April 27, 2022
PubMed

Insights

More tracheal intubation attempts in extremely preterm infants correlated with increased mortality and adverse events. Provider experience may be key to reducing complications and improving outcomes for these vulnerable newborns.

Area of Science:

  • Neonatal Medicine
  • Pediatric Critical Care
  • Respiratory Care

Background:

  • Tracheal intubation (TI) is a common procedure in extremely preterm infants.
  • The number of TI attempts may influence clinical outcomes.
  • Understanding this association is crucial for optimizing care in neonatal intensive care units (NICUs).

Purpose of the Study:

  • To investigate the relationship between the number of tracheal intubation attempts and clinical outcomes in extremely preterm infants.
  • To identify factors associated with TI success and adverse events.

Main Methods:

  • Single-center retrospective cohort study.
  • Inclusion criteria: infants born at ≤28 weeks gestation intubated within the first four postnatal days.
  • Analysis of infant, provider, and practice characteristics, and clinical outcomes stratified by TI attempt groups (1, 2, ≥3).

Main Results:

  • Ninety-nine infants were analyzed.
  • Increasing TI attempts were significantly associated with increased risk of death (p=0.004) and tracheal intubation-associated events (TIAEs; p=0.004).
  • A significant association was also found with the training level of the first attempt provider (p=0.002); no association with severe intraventricular hemorrhage (IVH) or other prematurity complications.

Conclusions:

  • The number of tracheal intubation attempts is linked to higher mortality and adverse events in extremely preterm infants.
  • Careful selection of experienced providers for initial intubation attempts may reduce TIAEs and improve patient outcomes.
Abstract

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