窒息供氧以防止 NICU 插管期间氧饱和度下降-猫眼课题宝

窒息供氧以防止 NICU 插管期间氧饱和度下降

批准号：

10570957

负责人：

Elizabeth Foglia

金额：

$21.43万

依托单位：

UNIVERSITY OF PENNSYLVANIA

依托单位国家：

美国

项目类别：

财政年份：

2022

资助国家：

美国

项目状态：

未结题

起止时间：

2022-02-11 至 2025-01-31

来源：

https://reporter.nih.gov/project-details/10570957

关键词：

Academy Accident and Emergency department Adherence Adult Adverse event Air American Blood gas Cannulas Cardiopulmonary Resuscitation Caring Child Childhood Complex Control Groups Critical Illness Data Development Emergency Situation Ensure Evaluation Event Funding Future Gestational Age Heart Rate Human Hyperoxia Hypoxia Infant Informed Consent Intensive Care Units Intervention Intervention Studies Intratracheal Intubation Intubation Investigation Knowledge Laryngoscopy Life Lung Masks Methodology Methods Multicenter Studies National Institute of Child Health and Human Development Neonatal Neonatal Intensive Care Units Neurodevelopmental Impairment Nose Operating Rooms Outcome Oxygen Patients Pediatrics Pennsylvania Performance Phase Physiology Population Premedication Procedures Process Process Assessment Protocols documentation Publishing Pulse Oximetry Randomized Randomized, Controlled Trials Recommendation Regimen Registries Research Risk Running Safety Secondary to Site Time Titrations Trauma Universities Video Recording adverse outcome arm clinical practice design experience group intervention high risk improved medication administration neonatal morbidity novel pediatric patients performance site prevent primary outcome prospective randomized trial respiratory routine provider safety outcomes secondary outcome success supplemental oxygen tool treatment arm ventilation

中文摘要

翻译

对于危重婴儿来说，气管插管(TI)是一种常见的、救命的、高风险的手术。在NICU环境下进行的气管插管中，18%会发生不良事件，几乎一半 (48%)新生儿重症监护病房插管并发严重的氧减饱和(≥下降20% 脉搏血氧饱和度[SpO2])。严重的去饱和度现在被认为是一个重要的导致新生儿发病率和神经发育结果受损的因素。虽然可以修改已经确定了预防不良气管插管相关事件的因素，有以下几种持续预防插管期间严重氧减饱和的有限干预措施 NICU患者。在NICU环境下插管期间的典型做法是在喉镜检查和气管插管尝试。患者在此期间经常出现呼吸暂停，因为给药前给药，这是美国科学院推荐的一种做法儿科。呼吸暂停氧合是一种通过鼻腔提供自由流动氧气的策略。喉镜检查和气管插管时的插管。窒息氧合已被证明成人和年龄较大的儿童在插管期间防止或推迟氧气减饱和。到目前为止，没有已发表的研究已系统地评估了气管插管期间呼吸暂停氧合的影响。适用于NICU环境中的婴儿。在这个R21应用中，我们提出了一项试点随机试验在新生儿重症监护室接受气管插管的28周校正胎龄的婴儿≥ 设置以确定是否有呼吸暂停氧合，而不是呼吸支持或氧气尝试喉镜和气管插管，减少血氧饱和度下降的幅度在气管插管期间。

英文摘要

Tracheal Intubation (TI) is a common, life-saving, high-risk procedure for critically ill infants. Adverse events occur in 18% of tracheal intubations performed in the NICU setting, and almost half (48%) of NICU intubations are complicated by severe oxygen desaturation (≥20% decline in pulse oximetry saturation [SpO2]). Severe desaturation is now recognized as an important contributor to neonatal morbidity and impaired neurodevelopmental outcomes. While modifiable factors have been identified that prevent adverse tracheal intubation associated events, there are limited interventions that consistently prevent severe oxygen desaturation during intubation in NICU patients. Typical practice during intubation in the NICU setting is to remove respiratory support during laryngoscopy and tracheal intubation attempts. Patients are often apneic during this period due to pre-medication administration, a practice that is recommended by the American Academy of Pediatrics. Apneic oxygenation is a strategy in which free flowing oxygen is provided via nasal cannula during laryngoscopy and tracheal intubation. Apneic oxygenation has been demonstrated to prevent or delay oxygen desaturation during intubation in adults and older children. To date, no published studies have systematically assessed the impact of apneic oxygenation during intubation for infants in the NICU setting. In this R21 application we propose a pilot randomized trial of infants ≥28 weeks corrected gestational age who undergo tracheal intubation in the NICU setting to determine if apneic oxygenation, compared with no respiratory support or oxygen during laryngoscopy and tracheal intubation attempt, reduces the magnitude of decline in oxygen saturation during tracheal intubation.

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