Failed endotracheal intubation and adverse outcomes among extremely low birth weight infants.

Wallenstein et al, J Perinatol. 2016 Feb

Abstract

OBJECTIVE:

To quantify the importance of successful endotracheal intubation on the first attempt among extremely low birth weight (ELBW) infants who require resuscitation after delivery.

RESULTS:

The study sample included 88 ELBW infants. Forty percent were intubated on the first attempt and 60% required multiple intubation attempts. Death or neurodevelopmental impairment occurred in 29% of infants intubated on the first attempt, compared with 53% of infants that required multiple attempts, adjusted odds ratio 0.4 (95% confidence interval 0.1 to 1.0), P<0.05.

CONCLUSION:

Successful intubation on the first attempt is associated with improved neurodevelopmental outcomes among ELBW infants. This study confirms the importance of rapid establishment of a stable airway in ELBW infants requiring resuscitationafter birth and has implications for personnel selection and role assignment in the delivery room.