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Does videolaryngoscopy improve tracheal intubation first attempt success in the NICUs? A report from the NEAR4NEOS

Journal of Perinatology volume 42, pages 1210–1215 (2022)Cite this article

Subjects

Abstract

Objective

We hypothesized that videolaryngoscope use for tracheal intubations would differ across NICUs, be associated with higher first attempt success and lower adverse events.

Study design

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.

Results

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).

Conclusion

Videolaryngoscope use is variable, not independently associated with higher first attempt success but associated with fewer tracheal intubation associated events.

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Fig. 1: Videolaryngoscope use in the Neonatal Intensive Care Units.

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Data availability

The datasets analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank the healthcare teams at participating NEAR4NEOS sites for their diligent completion of NEAR4NEOS data collection forms. They also like to thank Hayley Buffman at Children’s Hospital of Philadelphia as a coordinator for the NEAR4NEOS collaborative.

Funding

This study was supported by Eunice Kennedy Shriver NICHD R21 HD089151.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, Université de Montréal, Montreal, Canada

    Ahmed Moussa

  2. Department of Pediatrics, Division of Neonatology, University of Washington School of Medicine, Seattle, WA, USA

    Taylor Sawyer & Mihai Puia-Dumitrescu

  3. Department of Pediatrics, Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Elizabeth E. Foglia & Anne Ades

  4. Respiratory Therapy Department, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Natalie Napolitano

  5. Department of Pediatrics, Penn State Children’s Hospital, Penn State College of Medicine, Hershey, PA, USA

    Kristen M. Glass

  6. Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Yale University School of Medicine, New Haven, CT, USA

    Lindsay Johnston

  7. Universitätsklinikum Schleswig-Holstein, Campus Luebeck, Lübeck, Germany

    Philipp Jung

  8. Department of Pediatrics, Dartmouth-Hitchcock Health System, Lebanon, NH, USA

    Neetu Singh

  9. KK Women’s and Children’s Hospital, Singapore, Singapore

    Bin Huey Quek

  10. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA

    James Barry & Jeanne Zenge

  11. Department of Pediatrics, WakeMed Health and Hospitals, Raleigh, NC, USA

    Stephen DeMeo

  12. Department of Pediatrics, University of Calgary, Alberta, Canada

    Ayman Abou Mehrem

  13. Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Vinay Nadkarni & Akira Nishisaki

Authors
  1. Ahmed Moussa
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  2. Taylor Sawyer
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  3. Mihai Puia-Dumitrescu
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  4. Elizabeth E. Foglia
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  5. Anne Ades
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  6. Natalie Napolitano
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  7. Kristen M. Glass
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  8. Lindsay Johnston
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  17. Akira Nishisaki
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Consortia

National Emergency Airway Registry for Neonates (NEARNEOS) investigators

  • Ahmed Moussa
  • , Taylor Sawyer
  • , Mihai Puia-Dumitrescu
  • , Elizabeth E. Foglia
  • , Anne Ades
  • , Natalie Napolitano
  • , Kristen M. Glass
  • , Lindsay Johnston
  • , Philipp Jung
  • , Neetu Singh
  • , Bin Huey Quek
  • , James Barry
  • , Jeanne Zenge
  • , Stephen DeMeo
  • , Ayman Abou Mehrem
  • , Vinay Nadkarni
  •  & Akira Nishisaki

Contributions

AM has contributed to conception and design, acquisition of data, analysis and interpretation of data. He has written the first draft of this specific article and modified subsequent drafts until all authors approved the final version of the article. TJ, MPD, EEF, AA, NN, KMG, LJ, PJ, NS, BHQ, JB, JZ, SD, AAM and VN have contributed to acquisition of data and revised the article critically for important intellectual content. AN has contributed to conception and design, acquisition of data, analysis and interpretation of data; and revised the article critically for important intellectual content. All authors agree to be accountable for all aspects of the work. They ensure that questions relating to accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors have approved the final version of the article as sent to Journal of Perinatology.

Corresponding author

Correspondence to Ahmed Moussa.

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The authors declare no competing interests.

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Moussa, A., Sawyer, T., Puia-Dumitrescu, M. et al. Does videolaryngoscopy improve tracheal intubation first attempt success in the NICUs? A report from the NEAR4NEOS. J Perinatol 42, 1210–1215 (2022). https://doi.org/10.1038/s41372-022-01472-9

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