多次插管尝试对新生儿气管插管相关不良事件的影响：来自NEAR4NEOS的报告
Impact of multiple intubation attempts on adverse tracheal intubation associated events in neonates: a report from the NEAR4NEOS.
作者信息
Singh Neetu, Sawyer Taylor, Johnston Lindsay C, Herrick Heidi M, Moussa Ahmed, Zenge Jeanne, Jung Philipp, DeMeo Stephen, Glass Kristen, Howlett Alexandra, Shults Justine, Barry James, Brei Brianna K, Kim Jae H, Quek Bin Huey, Tingay David, Mehrem Ayman Abou, Napolitano Natalie, Nishisaki Akira, Foglia Elizabeth E
机构信息
Department of Pediatrics, Children's Hospital at Dartmouth, Lebanon, NH, USA.
Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
出版信息
J Perinatol. 2022 Sep;42(9):1221-1227. doi: 10.1038/s41372-022-01484-5. Epub 2022 Aug 18.
OBJECTIVE
To determine the relationship between number of attempts and adverse events during neonatal intubation.
STUDY DESIGN
A retrospective study of prospectively collected data of intubations in the delivery room and NICU from the National Emergency Airway Registry for Neonates (NEAR4NEOS) in 17 academic centers from 1/2016 to 12/2019. We examined the association between tracheal intubation attempts [1, 2, and ≥3 (multiple attempts)] and clinical adverse outcomes (any tracheal intubation associated events (TIAE), severe TIAE, and severe oxygen desaturation).
RESULTS
Of 7708 intubations, 1474 (22%) required ≥3 attempts. Patient, provider, and practice factors were associated with higher TI attempts. Increasing intubation attempts was independently associated with a higher risk for TIAE. The adjusted odds ratio for TIAE and severe oxygen desaturation were significantly higher in TIs with 2 and ≥3 attempts than with one attempt.
CONCLUSION
The risk of adverse safety events during intubation increases with the number of intubation attempts.
目的
确定新生儿插管过程中尝试次数与不良事件之间的关系。
研究设计
一项回顾性研究，对2016年1月至2019年12月期间17个学术中心的国家新生儿紧急气道注册系统（NEAR4NEOS）在产房和新生儿重症监护病房（NICU）进行插管的前瞻性收集数据进行分析。我们研究了气管插管尝试次数[1次、2次和≥3次（多次尝试）]与临床不良结局（任何与气管插管相关的事件（TIAE）、严重TIAE和严重氧饱和度下降）之间的关联。
结果
在7708次插管中，1474次（22%）需要≥3次尝试。患者、医护人员和操作因素与更高的气管插管尝试次数相关。插管尝试次数增加与TIAE风险升高独立相关。与单次尝试相比，2次和≥3次尝试的气管插管中，TIAE和严重氧饱和度下降的校正比值比显著更高。
结论
插管过程中不良安全事件的风险随着插管尝试次数的增加而增加。
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