RT Journal Article
SR Electronic
T1 Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP fetalneonatal-2020-319709
DO 10.1136/archdischild-2020-319709
A1 Brianna K Brei
A1 Taylor Sawyer
A1 Rachel Umoren
A1 Megan M Gray
A1 Jeanne Krick
A1 Elizabeth E Foglia
A1 Anne Ades
A1 Kristen Glass
A1 Jae H Kim
A1 Neetu Singh
A1 Philipp Jung
A1 Lindsay Johnston
A1 Ahmed Moussa
A1 Natalie Napolitano
A1 James Barry
A1 Jeanne Zenge
A1 Binhuey Quek
A1 Stephen D DeMeo
A1 Justine Shults
A1 Jennifer Unrau
A1 Vinay Nadkarni
A1 Akira Nishisaki
A1 ,
YR 2021
UL http://fn.bmj.com/content/early/2021/01/20/archdischild-2020-319709.abstract
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.