Failed Endotracheal Intubation and Adverse Outcomes Among Extremely Low Birth Weight Infants

Details

• Alternative Title:
  J Perinatol
• Personal Author:
  Wallenstein, Matthew B. ; Birnie, Krista L. ; Arain, Yassar H. ; Yang, Wei ; Yamada, Nicole K. ; Huffman, Lynne C. ; Palma, Jonathan P. ; Chock, Valerie Y. ; Shaw, Gary M. ; Stevenson, David K.
• Description:
  OBJECTIVE
  
  To quantify the importance of successful endotracheal intubation on the first attempt among extremely low birth weight (ELBW) infants who require resuscitation after delivery.
  
  STUDY DESIGN
  
  A retrospective chart review was conducted for all ELBW infants ≤1000 g born between January 2007 and May 2014 at a level IV neonatal intensive care unit. Infants were included if intubation was attempted during the first five minutes of life, or if intubation was attempted during the first 10 minutes of life with heart rate < 100. The primary outcome was death or neurodevelopmental impairment. The association between successful intubation on the first attempt and the primary outcome was assessed using multivariable logistic regression with adjustment for birth weight, gestational age, gender, and antenatal steroids.
  
  RESULTS
  
  The study sample included 88 ELBW infants. Forty-percent were intubated on the first attempt and 60% required multiple intubation attempts. Death or neurodevelopmental impairment occurred in 29% of infants intubated on the first attempt, compared to 53% of infants that required multiple attempts, adjusted odds ratio 0.4 (95% confidence interval 0.1 - 1.0), p < 0.05.
  
  CONCLUSION
  
  Successful intubation on the first attempt is associated with improved neurodevelopmental outcomes among ELBW infants. This study confirms the importance of rapid establishment of a stable airway in ELBW infants requiring resuscitation after birth and has implications for personnel selection and role assignment in the delivery room.
  
  
• Subjects:
  Article Endotracheal Intubation Extremely Low Birth Weight Failed Intubation Intubation Attempt Neurodevelopmental Impairment Resuscitation
• Source:
  J Perinatol. 36(2):112-115.
• Pubmed ID:
  26540244
• Pubmed Central ID:
  PMC4731260
• Document Type:
  Journal Article
• Funding:
  U01 DD001033/DD/NCBDD CDC HHS/United States
• Volume:
  36
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2dcbbe94a6ef04e9325658e9087e03c369d72247f77a4bd4975d67d11c2fe0ab
• Download URL:
  https://stacks.cdc.gov/view/cdc/37819/cdc_37819_DS1.pdf
• File Type:
  [PDF - 125.39 KB ]