Premedication with paralysis improves intubation success and decreases adverse events in very low birth weight infants: a prospective cohort study

Journal of Perinatology : Official Journal of the California Perinatal Association
Jeanne KrickTaylor Sawyer

Abstract

To characterize the impact of premedication with and without a paralytic agent on the safety of tracheal intubation (TI) in infants ≤1500 g. A prospective observational cohort study between February 2015 and June 2017. The primary outcomes were associations between the use of different premedication regimens with number of TI attempts, TI adverse events (TIAEs), and changes in heart rate. Data were collected on 237 TIs. Median postmenstrual age at intubation was 28 completed weeks and weight was 953 g. Premedication with a paralytic was associated with fewer intubation attempts compared to premedication without a paralytic (p = 0.037). Premedication with a paralytic was associated with fewer TIAEs (p < 0.001) and less bradycardia compared to the other two regimens (p = 0.003) compared to premedication without a paralytic. Premedication with a paralytic was associated with fewer intubation attempts, fewer TIAEs, and less bradycardia. Premedication with a paralytic may improve intubation safety in VLBWs.

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Citations

Feb 24, 2019·Archives of Disease in Childhood. Fetal and Neonatal Edition·Taylor SawyerUNKNOWN National Emergency Airway Registry for Neonates (NEAR4NEOS) investigators
May 3, 2020·NeoReviews·Taylor Sawyer, Kaalan Johnson
Apr 4, 2019·Journal of Perinatology : Official Journal of the California Perinatal Association·Yuri OzawaUNKNOWN National Emergency Airway Registry for Neonates (NEAR4NEOS) Investigators
Aug 1, 2019·American Journal of Perinatology·Rachel A UmorenUNKNOWN National Emergency Airway Registry for Neonates (NEAR4NEOS) Investigators
May 2, 2021·Archives of Disease in Childhood. Fetal and Neonatal Edition·Radhika KothariEoin O'Currain
Sep 30, 2021·Journal of Perinatology : Official Journal of the California Perinatal Association·Rebecca ShayJames S Barry

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