TY - JOUR
T1 - Associations between family presence and neonatal intubation outcomes
T2 - A report from the National Emergency Airway Registry for Neonates: NEAR4NEOS
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
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - 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.
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.
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U2 - 10.1136/archdischild-2020-319709
DO - 10.1136/archdischild-2020-319709
M3 - Article
C2 - 33478956
AN - SCOPUS:85100017122
SN - 1359-2998
VL - 106
SP - 392
EP - 397
JO - Archives of Disease in Childhood: Fetal and Neonatal Edition
JF - Archives of Disease in Childhood: Fetal and Neonatal Edition
IS - 4
ER -