Providing Oxygen During Intubation in the NICU Trial
Apneic Oxygenation to Prevent Oxygen Desaturation During Intubation in the NICU
University of Pennsylvania
110 participants
Jul 20, 2022
INTERVENTIONAL
Conditions
Summary
Tracheal intubation in the NICU is frequently complicated by severe oxygen desaturation. Apneic oxygenation, a method of applying free flowing oxygen via nasal cannula to apneic patients undergoing intubation, prevents or delays oxygen desaturation during intubation in adults and older children. We propose to enroll patients at two sites (Hospital of the University of Pennsylvania and Children's Hospital of Philadelphia) in a randomized trial in infants undergoing intubation in the NICU to determine if apneic oxygenation, compared with no respiratory support or oxygen during laryngoscopy and intubation attempts (standard care), reduces the magnitude of oxygen desaturation during tracheal intubation encounters.
Eligibility
Inclusion Criteria3
- Infants ≥28 weeks corrected gestational age
- Undergoing intubation in the NICU
- Pre-medication (including paralytic) administered
Exclusion Criteria13
- Critical Airway or Airway Anomaly
- Unstable hemodynamics (i.e. active resuscitation)
- Unable to achieve SpO2 ≥90% prior to intubation attempt
- Intubation performed by Non-NICU provider (i.e. anesthesiology or ENT)
- Unrepaired congenital diagrammatic hernia
- Tracheal esophageal fistula within 2 weeks of repair
- Tracheostomy
- Previous enrollment in the trial
- Nasal intubation
- COVID person under investigation (PUI) or COVID positive
- Cyanotic heart disease
- Receiving Extracorporeal Membrane Oxygenation support
- Conjoined twins
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Interventions
Nasal cannula at a rate of 6L/min with 100% FiO2 during laryngoscopy and intubation attempt(s)
No respiratory support during laryngoscopy and intubation attempt(s) (current standard of care)
Locations(1)
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NCT05451953