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J Pediatr. 2016 Oct;177:108-113. doi: 10.1016/j.jpeds.2016.06.051. Epub 2016 Jul 26.

Intubation Attempts Increase the Risk for Severe Intraventricular Hemorrhage in Preterm Infants-A Retrospective Cohort Study.

Author information

1
Department of Pediatrics, University of California, San Diego, CA. Electronic address: csauer@ucsd.edu.
2
Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.
3
Department of Pediatrics, University of California, San Diego, CA.
4
Clinical and Translational Research Institute, University of California, San Diego, CA.
5
Department of Pediatrics, Columbia University, College of Physicians and Surgeons, New York, NY.

Abstract

OBJECTIVE:

To evaluate whether neonates exposed to multiple intubation attempts within the first 4 days after birth have an increased incidence of intraventricular hemorrhage (IVH).

STUDY DESIGN:

This is a retrospective cohort study of infants intubated during the first 4 days after birth. Infants had birth weights (BWs) less than 1500 g and were admitted to the neonatal intensive care unit (NICU) at the University of California, San Diego, between January 1, 2005, and July 30, 2009. A subgroup analysis was done for infants with BW less than 750 g.

RESULTS:

A total of 308 infants with BW <1500 g, including 102 with a BW <750 g, were intubated within the first 4 days of life. The number of intubation attempts was significantly greater in infants with a BW <750 g who had severe IVH compared with those with mild or no IVH (OR 1.395, 95% CI 1.090-1.786, P = .008). For infants with BW <1500 g, the number of intubation attempts in the delivery room was significantly greater for infants with severe IVH (OR 1.317, 95% CI 1.052-1.649, P = .016).

CONCLUSION:

Increased intubation attempts were associated with increased incidence of severe IVH in infants with BW less than 750 g and in infants less than 1500 g who were intubated only in the delivery room. Prospective studies are needed to further evaluate the relationship between intubation attempts and severe IVH.

KEYWORDS:

Neonatal Intensive Care Unit; delivery room; neonate; resuscitation

PMID:
27470688
DOI:
10.1016/j.jpeds.2016.06.051
[Indexed for MEDLINE]

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