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Apneic time during intubation in critically ill children
Theerapon Jariyasakoolroj1,2, Taiki Kojima3, Shefali Godara4
1Center for Simulation, Advanced Education and Innovation, Children's Hospital of Philadelphia, Philadelphia, PA, USA. nui_th2@hotmail.com.
Pediatric Research
|January 13, 2026
Summary
Prolonged apneic time during pediatric tracheal intubation is not linked to oxygen desaturation. However, using apneic oxygenation significantly lowers desaturation risk in critically ill children.
Area of Science:
- Pediatric Critical Care Medicine
- Airway Management
- Respiratory Physiology
Background:
- Prolonged apneic periods during tracheal intubation in children can lead to oxygen desaturation.
- Identifying factors associated with extended apneic times is crucial for patient safety.
Purpose of the Study:
- To determine factors linked to prolonged apneic times during pediatric tracheal intubation.
- To investigate the association between apneic duration and oxygen desaturation in children.
Main Methods:
- Prospective observational study of 204 children under 18 undergoing oral tracheal intubation.
- Apneic time measured, with a 54-second cutoff for 'long' apneic time.
- Oxygen desaturation defined as SpO2 <90% in children with baseline SpO2 >90%.
Main Results:
- Median apneic time was 54 seconds; longer apneic times were more frequent in infants.
- Apneic time did not vary by difficult airway history, provider, or laryngoscope type.
- Oxygen desaturation rates were similar between short and long apneic groups; apneic oxygenation reduced desaturation risk.
Conclusions:
- Patient age was associated with longer apneic times during tracheal intubation.
- Apneic time duration was not independently linked to oxygen desaturation.
- Apneic oxygenation use was significantly associated with a lower incidence of oxygen desaturation, supporting its routine use.
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