Abstract
Aims:
To determine the extent and type of premedication used for elective endotracheal intubation in neonatal intensive care units (NICUs).
Methods:
A pretested questionnaire was distributed via e-mail to the program directors of the neonatology divisions with accredited fellowship programs in Neonatal-Perinatal Medicine in the United States.
Results:
Of the 100 individuals contacted, 78 (78%) participated in the survey. Only 34 of the 78 respondents (43.6%) always use any premedication for elective intubation. Nineteen respondents (24.4%) reported to have a written policy regarding premedication. Morphine or fentanyl was used most commonly (57.1%), with a combination of opioids and midazolam or other benzodiazepines used less frequently. Fourteen respondents (25%) also use muscle relaxants with sedation for premedication, but only nine respondents combined paralysis with atropine and sedation.
Conclusion:
Most neonatology fellowship program directors do not report always using premedication for newborns before elective endotracheal intubation despite strong evidence of physiologic and practical benefits. Only a minority of the NICUs has written guidelines for sedation, which may preclude effective auditing of this practice. Educational interventions may be necessary to ensure changes in clinical practice.
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Sarkar, S., Schumacher, R., Baumgart, S. et al. Are newborns receiving premedication before elective intubation?. J Perinatol 26, 286–289 (2006). https://doi.org/10.1038/sj.jp.7211499
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DOI: https://doi.org/10.1038/sj.jp.7211499
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