Difficult tracheal intubation in neonates and infants. NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE): a prospective European multicentre observational study

Male paediatric Time Factors morbidity Severity of Illness Index 0302 clinical medicine Risk Factors info:eu-repo/classification/ddc/617 Age Factor Anesthesia Prospective Studies Hypoxia Medical Audit ddc:617 airways; anaesthesia; difficult intubation; infants; morbidity; mortality; neonates; paediatric. infants Incidence Age Factors anaesthesia 3. Good health Europe Treatment Outcome Female Human Time Factor 610 Medicine & health Anesthesia/adverse effects/mortality Risk Assessment Europe/epidemiology Laryngoscopy/adverse effects/mortality 03 medical and health sciences Hypoxia/diagnosis/epidemiology/mortality Intubation, Intratracheal difficult intubation Humans Laryngoscopy Risk Factor Infant, Newborn Infant Newborn infant mortality neonates Intratracheal Prospective Studie airway Intubation, Intratracheal/adverse effects/mortality neonate Intubation airways
DOI: 10.1016/j.bja.2021.02.021 Publication Date: 2021-04-01T06:01:43Z
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ABSTRACT
Neonates and infants are susceptible to hypoxaemia in the perioperative period. The aim of this study was analyse interventions related anaesthesia tracheal intubations European cohort identify their clinical consequences.We performed a secondary analysis multicentre observational trial (NEonate Children audiT Anaesthesia pRactice IN Europe [NECTARINE]) neonates small with difficult intubation. primary endpoint incidence intubation complications. endpoints were risk factors for severe attributed airway management, 30 90 day outcomes.Tracheal planned 4683 procedures. Difficult intubation, defined as two failed attempts direct laryngoscopy, occurred 266 children (271 procedures) an (95% confidence interval [CI]) 5.8% CI, 5.1-6.5). Bradycardia 8% cases whereas significant decrease oxygen saturation (SpO2<90% 60 s) reported 40%. No associated could be identified among co-morbidities, surgical, or management. Using propensity scoring adjust confounders, did not lead increase morbidity mortality.The results present demonstrate high less than weeks post-conceptual age commonly resulting hypoxaemia. Reassuringly, mortality at days increased by occurrence event.NCT02350348.
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