Premedication With Neuromuscular Blockade and Sedation During Neonatal Intubation Is Associated With Fewer Adverse Events - PubMed

Premedication With Neuromuscular Blockade and Sedation During Neonatal Intubation Is Associated With Fewer Adverse Events - PubMed

Premedication With Neuromuscular Blockade and Sedation During Neonatal Intubation Is Associated With Fewer Adverse Events

Yuri Ozawa 1, Anne Ades 2 3, Elizabeth E Foglia 3, Stephen DeMeo 4, James Barry 5, Taylor Sawyer 6, Neetu Singh 7, Kristen Glass 8, Philipp Jung 9, Bin Huey Quek 10, Lindsay Johnston 11, Jae Kim 12, Natalie Napolitano 13, Justine Shults 14, Vinay M Nadkarni 2 15, Akira Nishisaki 2 15, National Emergency Airway Registry for Neonates (NEAR4NEOS) Investigators

Affiliations 

• PMID: 30940929
 
• DOI: 10.1038/s41372-019-0367-0

Abstract

Objective: To determine the impact of premedication for tracheal intubation (TI) on adverse TI associated events, severe oxygen desaturations, and first attempt success STUDY DESIGN: Retrospective cohort study in neonatal intensive care units (NICU) participating in the National Emergency Airway Registry for Neonates from 10/2014 to 6/2017. Premedication for TI was categorized as sedation with neuromuscular blockade, sedation only, or no medication.

Results: 2260 TIs were reported from 11 NICUs. Adverse TI associated events occurred less often in sedation with neuromuscular blockade group (10%) as compared to sedation only (29%), or no medication group (23%), p < 0.001. The adjusted odds ratio (aOR) for adverse TI associated events were: sedation with neuromuscular blockade aOR 0.48 (95%CI 0.34-0.65, p < 0.001) compared to no medication.

Conclusion: Use of sedation with neuromuscular blockade was associated with favorable TI outcomes. This study supports the recommendation for the standard use of sedation with neuromuscular blockade in non-emergency TIs.

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