In this analysis of 3,145 neonatal intubation encounters, there were important differences in the characteristics and outcomes between intubations that occurred in the delivery room versus neonatal intensive care unit setting.
Difficult intubations are common in the NICU and are associated with adverse event and severe oxygen desaturation. Difficult intubations occur more commonly in small preterm infants. The occurrence of a difficult intubation in other neonates is hard to predict due to the lack of sensitivity of bedside screening tests
Arch Dis Child Fetal Neonatal Ed
Difficult intubation prediction for neonatal intubation
Adverse TIAEs and severe oxygen desaturation events are common in the NICU setting. Modifiable risk factors associated with TIAEs identified include intubator training level and use of paralytic medications.
In this meta-analysis, sustained inflation was associated with similar risks of in-hospital mortality compared with standard therapy. Sustained inflation was associated with increased risk of mortality in the first 2 days compared with standard therapy, and there were no differences in the risk of any other secondary outcomes.
In this randomized clinical trial involving 426 infants that was stopped early due to suggestion of harm in the sustained inflation group, there was no significant difference in the rate of bronchopulmonary dysplasia or death at 36 weeks’ postmenstrual age for infants treated with sustained inflation vs standard resuscitation (63.7% vs 59.2%).
This inaugural report of over 1,000 delivery room cardiopulmonary resuscitation events in the multi-site American Heart Association Get with the Guidelines-Resuscitation Registry contributes to defining gestational-age specific survival outcomes.
In this article, we review the current evidence for interventions applied during neonatal transition (delivery room and first postnatal hours of life) to prevent BPD in extremely preterm infants: continuous positive airway pressure (CPAP), sustained lung inflation, supplemental oxygen use during neonatal resuscitation, and surfactant therapy including less-invasive surfactant administration
In this pilot trial, we demonstrated that intubation and ventilation prior to umbilical cord clamping is safe and feasible among infants with congenital diaphragmatic hernia and may result in short-term physiologic benefit
Effective ventilation is the cornerstone of neonatal resuscitation. In this article, we review the physiology of cardiopulmonary transition at birth, with particular attention to factors the caregiver should consider when providing ventilation.
Wearable eye-tracking technology is feasible to identify gaze fixation on the respiratory function monitor (RFM) display and is well accepted by providers. Neonatal providers look at exhaled tidal volume more than any other RFM parameter.
Smartphone-integrated consumer baby monitors that measure vital signs are popular among parents but are not regulated by the FDA. This study measured the accuracy of pulse oximetry-based consumer baby monitors using an FDA-cleared oximeter as a reference.
We studied the impact of "MROPSA" corrective steps on heart rate and tidal volumes during delivery room PPV for preterm infants. Ventilation corrective steps improved tidal volume delivery in some cases but worsened exhaled tidal volumes in others. Mask leak and airway obstruction were induced by some ventilation corrective maneuvers
PEA may be observed during resuscitation of critically ill newborns, as described in this report. Incor- poration of discrepant physical examination findings and nonpulsatile pulse oximetry waveforms with electronic heart rate monitoring may improve providers’ ability to rapidly recognize PEA.
We compared pulse oximetry measurement bias between infants with hypoxemia with either dark skin or light skin with Masimo Radical 7 and Nellcor Oximax. There was no significant difference in systematic bias based on skin pigment for either oximeter
We used eye tracking glasses to assess where team leaders focus their visual attention during neonatal resuscitation. We found systematic differences in eye tracking patterns between neonatologists and neonatal fellows
We assessed the accuracy of real-time delivery room resuscitation documentation. Real-time documentation correctly reflects interventions performed during delivery room resuscitation but is less accurate for early vital sign assessments.