PT  - JOURNAL ARTICLE
AU  - Brei, Brianna K
AU  - Sawyer, Taylor
AU  - Umoren, Rachel
AU  - Gray, Megan M
AU  - Krick, Jeanne
AU  - Foglia, Elizabeth E
AU  - Ades, Anne
AU  - Glass, Kristen
AU  - Kim, Jae H
AU  - Singh, Neetu
AU  - Jung, Philipp
AU  - Johnston, Lindsay
AU  - Moussa, Ahmed
AU  - Napolitano, Natalie
AU  - Barry, James
AU  - Zenge, Jeanne
AU  - Quek, Binhuey
AU  - DeMeo, Stephen D
AU  - Shults, Justine
AU  - Unrau, Jennifer
AU  - Nadkarni, Vinay
AU  - Nishisaki, Akira
ED  - , 
TI  - Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS
AID  - 10.1136/archdischild-2020-319709
DP  - 2021 Jan 21
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - fetalneonatal-2020-319709
4099  - http://fn.bmj.com/content/early/2021/01/20/archdischild-2020-319709.short
4100  - http://fn.bmj.com/content/early/2021/01/20/archdischild-2020-319709.full
AB  - Objective Describe the current practice of family presence during neonatal tracheal intubations (TIs) across neonatal intensive care units (NICUs) and examine the association with outcomes.Design Retrospective analysis of TIs performed in NICUs participating in the National Emergency Airway Registry for Neonates (NEAR4NEOS).Setting Thirteen academic NICUs.Patients Infants undergoing TI between October 2014 and December 2017.Main outcome measures Association of family presence with TI processes and outcomes including first attempt success (primary outcome), success within two attempts, adverse TI-associated events (TIAEs) and severe oxygen desaturation ≥20% from baseline.Results Of the 2570 TIs, 242 (9.4%) had family presence, which varied by site (median 3.6%, range 0%–33%; p<0.01). Family member was more often present for older infants and those with chronic respiratory failure. Fewer TIs were performed by residents when family was present (FP 10% vs no FP 18%, p=0.041). Among TIs with family presence versus without family presence, the first attempt success rate was 55% vs 49% (p=0.062), success within two attempts was 74% vs 66% (p=0.014), adverse TIAEs were 18% vs 20% (p=0.62) and severe oxygen desaturation was 49% vs 52%, (p=0.40). In multivariate analyses, there was no independent association between family presence and intubation success, adverse TIAEs or severe oxygen desaturation.Conclusion Family are present in less than 10% of TIs, with variation across NICUs. Even after controlling for important patient, provider and site factors, there were no significant associations between family presence and intubation success, adverse TIAEs or severe oxygen desaturation.