Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, WA, USA.
J Perinatol. 2018 Jun;38(6):681-686. doi: 10.1038/s41372-018-0082-2. Epub 2018 Feb 21.
To characterize the impact of premedication with and without a paralytic agent on the safety of tracheal intubation (TI) in infants ≤1500 g.
A prospective observational cohort study between February 2015 and June 2017. The primary outcomes were associations between the use of different premedication regimens with number of TI attempts, TI adverse events (TIAEs), and changes in heart rate.
Data were collected on 237 TIs. Median postmenstrual age at intubation was 28 completed weeks and weight was 953 g. Premedication with a paralytic was associated with fewer intubation attempts compared to premedication without a paralytic (p = 0.037). Premedication with a paralytic was associated with fewer TIAEs (p < 0.001) and less bradycardia compared to the other two regimens (p = 0.003) compared to premedication without a paralytic.
Premedication with a paralytic was associated with fewer intubation attempts, fewer TIAEs, and less bradycardia. Premedication with a paralytic may improve intubation safety in VLBWs.
描述在 1500g 以下的婴儿中，使用和不使用肌松剂进行预给药对气管插管（TI）安全性的影响。
这是一项 2015 年 2 月至 2017 年 6 月期间进行的前瞻性观察性队列研究。主要结局是不同预给药方案与 TI 尝试次数、TI 不良事件（TIAE）以及心率变化之间的关联。
共收集了 237 例 TI。插管时的中位校正孕周为 28 周，体重为 953g。与不使用肌松剂的预给药相比，使用肌松剂的预给药与插管尝试次数减少相关（p=0.037）。与不使用肌松剂的预给药相比，使用肌松剂的预给药与更少的 TIAE（p<0.001）和更少的心动过缓相关（p=0.003）。
使用肌松剂的预给药与插管尝试次数减少、TIAE 减少和心动过缓减少相关。在极低出生体重儿中，使用肌松剂进行预给药可能会提高插管安全性。
