Nasal versus oral endotracheal intubation in mechanically ventilated newborn infants in a tertiary care neonatal unit: a prospective randomized comparative analysis
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 6
Abstract
Backgrounds: Infants in the Neonatal Intensive Care Unit (NICU) are among the highest risk groups for adverse events in the hospital setting. In adult and pediatric intensive care units, adverse events related to endotracheal or tracheostomy tubes comprise a substantial proportion of total adverse events and lead to significant patient harm. Aim: we planned to conduct this study to compare the advantage and complication associated with nasal versus oral intubation for mechanical ventilation in newborn infants. Materials and Methods: Intubation was done with a standardized premedication with vecuronium and midazolam except for babies who required emergency intubation. Due to difficulty in procuring the opioids in the unit it was not included in premedication. Results: the incidence of trauma was found 15.15% of cases in nasal group where as 12.1% in oral group. However this difference between both the groups was statistically not significant (p=1.00). Only one baby in nasal group had severe septal necrosis where as palatal grooving was found none of oral cases. Conclusions: Adverse events are common in the NICU, occurring in 4 of 10 intubations. The odds of an adverse event doubled with increasing number of attempts and quadrupled in the emergent setting. Quality improvement efforts to address these factors are needed to improve patient safety
Authors and Affiliations
Dr. Bhabagrahi Mallick
Keywords
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