Department of Pediatrics, Division of Neonatology, Université de Montréal, Montreal, Canada.
Department of Pediatrics, Division of Neonatology, University of Washington School of Medicine, Seattle, WA, USA.
J Perinatol. 2022 Sep;42(9):1210-1215. doi: 10.1038/s41372-022-01472-9. Epub 2022 Aug 3.
We hypothesized that videolaryngoscope use for tracheal intubations would differ across NICUs, be associated with higher first attempt success and lower adverse events.
Data from the National Emergency Airway Registry for Neonates (01/2015 to 12/2017) included intubation with direct laryngoscope or videolaryngoscope. Primary outcome was first attempt success. Secondary outcomes were adverse tracheal intubation associated events and severe desaturation.
Of 2730 encounters (13 NICUs), 626 (23%) utilized a videolaryngoscope (3% to 64% per site). Videolaryngoscope use was associated with higher first attempt success (p < 0.001), lower adverse tracheal intubation associated events (p < 0.001), but no difference in severe desaturation. After adjustment, videolaryngoscope use was not associated with higher first attempt success (OR:1.18, p = 0.136), but was associated with lower tracheal intubation associated events (OR:0.45, p < 0.001).
Videolaryngoscope use is variable, not independently associated with higher first attempt success but associated with fewer tracheal intubation associated events.
我们假设，在新生儿重症监护病房（NICU）中，使用视频喉镜进行气管插管的方法存在差异，且与首次尝试成功率更高和不良事件发生率更低相关。
国家新生儿急症气道登记处（2015 年 1 月至 2017 年 12 月）的数据包括使用直接喉镜或视频喉镜进行的插管。主要结局为首次尝试成功率。次要结局为与气管插管相关的不良事件和严重低氧血症。
在 2730 次操作（涉及 13 个 NICU）中，626 次（23%）使用了视频喉镜（每个地点的使用率为 3%至 64%）。与直接喉镜相比，视频喉镜的使用与更高的首次尝试成功率（p<0.001）、更低的与气管插管相关的不良事件发生率（p<0.001）相关，但与严重低氧血症发生率无差异。调整后，视频喉镜的使用与更高的首次尝试成功率（比值比：1.18，p=0.136）无关，但与更低的与气管插管相关的不良事件发生率（比值比：0.45，p<0.001）相关。
视频喉镜的使用存在差异，与首次尝试成功率的提高无独立相关性，但与与气管插管相关的不良事件发生率的降低相关。
