术前用药对儿科和新生儿科实习生进行新生儿插管操作的影响。
Impact of premedication on neonatal intubations by pediatric and neonatal trainees.
作者信息
Le C N, Garey D M, Leone T A, Goodmar J K, Rich W, Finer N N
机构信息
Division of Perinatal-Neonatal Medicine, Department of Pediatrics, University of California, San Diego, Rady Children's Hospital of San Diego, San Diego, CA, USA.
Division of Neonatology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, USA.
出版信息
J Perinatol. 2014 Jun;34(6):458-60. doi: 10.1038/jp.2014.32. Epub 2014 Feb 27.
OBJECTIVE
To determine if premedication and training level affect the success rates of neonatal intubations.
STUDY DESIGN
We retrospectively reviewed a hospital-approved neonatal intubation database from 2003 to 2010. Intubation success rate was defined as the number of successful intubations divided by the total number of attempts, and then compared by trainee's experience level and the use of premedication. Premedication regimen included anticholinergic, analgesic and muscle relaxant agents.
RESULT
There were 169 trainees who completed 1071 successful intubations with 2694 attempts. The median success rate was 36% by all trainees, and improved with training level from 29% for pediatric trainees to 50% for neonatal trainees (P<0.001). Premedication was used in 58% of intubation attempts. The median success rate was double with premedication (43% versus 22%, P<0.001).
CONCLUSION
Neonatal endotracheal intubation is a challenge for trainees. Intubation success rates progressively improve with experience. Premedication is associated with improved success rates for all training levels.
目的
确定术前用药和培训水平是否会影响新生儿插管的成功率。
研究设计
我们回顾性分析了2003年至2010年医院批准的新生儿插管数据库。插管成功率定义为成功插管次数除以总尝试次数，然后按学员的经验水平和术前用药情况进行比较。术前用药方案包括抗胆碱能药、镇痛药和肌肉松弛剂。
结果
169名学员共进行了2694次插管尝试，其中1071次成功。所有学员的插管成功率中位数为36%，随着培训水平的提高，从儿科实习生的29%提高到新生儿实习生的50%（P<0.001）。58%的插管尝试使用了术前用药。使用术前用药时的成功率中位数翻倍（43%对22%，P<0.001）。
结论
新生儿气管插管对学员来说是一项挑战。插管成功率随着经验的增加而逐步提高。术前用药与所有培训水平的成功率提高相关。
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