Premedication practices for tracheal intubation in neonates transported by French medical transport teams: a prospective observational study.
Analgesics, Opioid
/ therapeutic use
Atropine
/ therapeutic use
Female
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Intubation, Intratracheal
/ adverse effects
Male
Midazolam
/ therapeutic use
Pain
/ epidemiology
Paris
Premedication
/ statistics & numerical data
Prospective Studies
Sufentanil
/ therapeutic use
epidemiology
intubation
neonatal intensive & critical care
neonatology
pain management
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
14 11 2019
14 11 2019
Historique:
entrez:
16
11
2019
pubmed:
16
11
2019
medline:
20
11
2020
Statut:
epublish
Résumé
Premedication practices for neonatal tracheal intubations have not yet been described for neonatal transport teams. Our objective is to describe the use of sedation/analgesia (SA) for tracheal intubations and to assess its tolerance in neonates transported by medical transport teams in France. This prospective observational study was part of the EPIPPAIN 2 project and collected around-the-clock data on SA practices in neonates intubated by all five paediatric medical transport teams of the Paris region during a 2-month period. Intubations were classified as emergent, semiemergent and non-emergent. Sedation level and conditions of intubation were assessed with the 40 neonates intubated in 28 different centres. The mean (SD) age was 34.9 (3.9) weeks, and 62.5% were intubated in the delivery room. 30/40 (75%) of intubations were performed with the use of SA. In 18/30 (60.0%) intubations performed with SA, the drug regimen was the association of sufentanil and midazolam. Atropine was given in 19/40 intubations. From the 16, 21 and 3 intubations classified as emergent, semiemergent and non-emergent, respectively, 8 (50%), 19 (90.5%) and 3 (100%) were performed with SA premedication. 79.3% of intubations performed with SA had TRACHEA scores of 3 or less. 22/40 (55%) infants had at least one of the following adverse events: muscle rigidity, bradycardia below 100/min, desaturation below 80% and nose or pharynx-larynx bleeding. 7/24 (29.2%) of those who had only one attempt presented at least one of these adverse events compared with 15/16 (93.8%) of those who needed two or more attempts (p<0.001). SA premedication is largely feasible for tracheal intubations performed in neonates transported by medical transport teams including intubations judged as emergent or semiemergent. NCT01346813; Results.
Identifiants
pubmed: 31727669
pii: bmjopen-2019-034052
doi: 10.1136/bmjopen-2019-034052
pmc: PMC6886912
doi:
Substances chimiques
Analgesics, Opioid
0
Atropine
7C0697DR9I
Sufentanil
AFE2YW0IIZ
Midazolam
R60L0SM5BC
Banques de données
ClinicalTrials.gov
['NCT01346813']
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e034052Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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