Premedication practices for neonatal tracheal intubation: Results from the EPIPPAIN 2 prospective cohort study and comparison with EPIPPAIN 1.
evidence‐based practice
neonate
pain
premedication
tracheal intubation
Journal
Paediatric & neonatal pain
ISSN: 2637-3807
Titre abrégé: Paediatr Neonatal Pain
Pays: United States
ID NLM: 101777799
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
25
11
2020
revised:
17
02
2021
accepted:
03
03
2021
entrez:
13
5
2022
pubmed:
14
5
2022
medline:
14
5
2022
Statut:
epublish
Résumé
To describe the frequency and nature of premedication practices for neonatal tracheal intubation (TI) in 2011; to identify independent risk factors for the absence of premedication; to compare data with those from 2005 and to confront observed practices with current recommendations. Data concerning TI performed in neonates during the first 14 days of their admission to participating neonatal/pediatric intensive care units were prospectively collected at the bedside. This study was part of the Epidemiology of Procedural Pain in Neonates study (EPIPPAIN 2) conducted in 16 tertiary care units in the region of Paris, France, in 2011. Multivariate analysis was used to identify factors associated with premedication use and multilevel analysis to identify center effect. Results were compared with those of the EPIPPAIN 1 study, conducted in 2005 with a similar design, and to a current guidance for the clinician for this procedure. One hundred and twenty-one intubations carried out in 121 patients were analyzed. The specific premedication rate was 47% and drugs used included mainly propofol (26%), sufentanil (24%), and ketamine (12%). Three factors were associated with the use of a specific premedication: nonemergent TI (Odds ratio (OR) [95% CI]: 5.3 [1.49-20.80]), existence of a specific written protocol in the ward (OR [95% CI]:4.80 [2.12-11.57]), and the absence of a nonspecific concurrent analgesia infusion before TI (OR [95% CI]: 3.41 [1.46-8.45]). No center effect was observed. The specific premedication rate was lower than the 56% rate observed in 2005. The drugs used were more homogenous and consistent with the current recommendations than in 2005, especially in centers with a specific written protocol. Premedication use prior to neonatal TI was low, even for nonemergent procedures. Scientific consensus, implementation of international or national recommendations, and local written protocols are urgently needed to improve premedication practices for neonatal intubation.
Identifiants
pubmed: 35547594
doi: 10.1002/pne2.12048
pii: PNE212048
pmc: PMC8975199
doi:
Types de publication
Journal Article
Langues
eng
Pagination
46-58Informations de copyright
© 2021 The Authors. Paediatric and Neonatal Pain published by John Wiley & Sons Ltd.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to declare.
Références
JAMA. 2008 Jul 2;300(1):60-70
pubmed: 18594041
Resuscitation. 2013 Oct;84(10):1359-64
pubmed: 23562374
J Perinatol. 2015 Jun;35(6):415-8
pubmed: 25569679
Paediatr Neonatal Pain. 2021 Apr 04;3(2):46-58
pubmed: 35547594
Arch Dis Child Fetal Neonatal Ed. 2019 Sep;104(5):F461-F466
pubmed: 30796059
J Pediatr. 2016 Oct;177:108-113
pubmed: 27470688
Lancet. 1993 Jul 24;342(8865):193-8
pubmed: 8100927
J Perinatol. 2006 May;26(5):286-9
pubmed: 16598295
Acta Paediatr. 2019 Feb;108(2):208-217
pubmed: 30290021
Pediatrics. 2007 Jun;119(6):e1248-55
pubmed: 17485450
Br J Pharmacol. 2005 Sep;146(2):189-97
pubmed: 15997239
Crit Care Med. 1989 Dec;17(12):1293-6
pubmed: 2686934
J Perinatol. 2014 Jun;34(6):458-60
pubmed: 24577435
J Pediatr. 2016 Jan;168:62-66.e6
pubmed: 26541424
Pediatrics. 2019 Jan;143(1):
pubmed: 30538147
Am J Perinatol. 2020 Dec;37(14):1417-1424
pubmed: 31365934
Am J Perinatol. 2015 Jul;32(9):821-4
pubmed: 25607227
Semin Perinatol. 2007 Oct;31(5):303-8
pubmed: 17905185
Arch Dis Child Fetal Neonatal Ed. 2018 May;103(3):F221-F226
pubmed: 28818854
Neonatology. 2019;116(1):10-16
pubmed: 30889585
J Perinatol. 2019 Jun;39(6):848-856
pubmed: 30940929
Anaesthesia. 2003 Aug;58(8):777-80
pubmed: 12859470
Pediatrics. 2010 Mar;125(3):608-15
pubmed: 20176672
BMJ Open. 2014 Feb 20;4(2):e004086
pubmed: 24556241
Pediatr Qual Saf. 2019 Nov 12;4(6):e234
pubmed: 32010860
Arch Dis Child Fetal Neonatal Ed. 2000 Jan;82(1):F38-41
pubmed: 10634840
Pediatr Crit Care Med. 2013 May;14(4):e169-75
pubmed: 23439457
J Perinatol. 2018 Jun;38(6):611-613
pubmed: 29930326
Arch Dis Child Fetal Neonatal Ed. 2006 Jul;91(4):F279-82
pubmed: 16464937
Am J Perinatol. 2018 Mar;35(4):336-344
pubmed: 29020695
J Perinatol. 2018 Jun;38(6):681-686
pubmed: 29467520
BMC Pediatr. 2014 May 07;14:120
pubmed: 24886350
Lancet Respir Med. 2015 Oct;3(10):796-812
pubmed: 26420017
JAMA. 2018 May 1;319(17):1790-1801
pubmed: 29715354
Anesthesiology. 2004 Aug;101(2):527-30
pubmed: 15277935
Neonatology. 2015;108(1):23-9
pubmed: 25967680
Paediatr Anaesth. 2009 Jul;19(7):653-8
pubmed: 19490437
Pediatrics. 2016 Oct;138(4):
pubmed: 27694281
J Perinatol. 2016 Feb;36(2):112-5
pubmed: 26540244
Pediatr Clin North Am. 1999 Dec;46(6):1249-84
pubmed: 10629684
Acta Paediatr. 2020 Jul;109(7):1369-1375
pubmed: 31797442
Acta Paediatr. 2013 Dec;102(12):e534-8
pubmed: 24015945
Arch Pediatr Adolesc Med. 2001 Feb;155(2):173-80
pubmed: 11177093
Pediatr Crit Care Med. 2016 Aug;17(8):721-6
pubmed: 27355825