Neonatal Respiratory Distress
Conditions
Keywords
Sedo-analgesia, laryngoscopy, neonatal ICU, intubation
Brief summary
This study is a national prospective survey on practices of premedication before laryngoscopy in neonates. The survey will evaluate adequation to the French best practice guidelines to improve their dissemination and to identify current practices of premedication before laryngoscopy in neonates in French units (agents, dosing, efficacy, safety)
Detailed description
Laryngoscopy for intubation or less invasive surfactant administration (LISA) in neonates is a stressful and painful procedure that necessitates a sedo-analgesia except in the case of an immediate life-threatening emergency. Nevertheless, there are discrepancies in premedication practices amongst neonatal units. In order to optimize analgesia before laryngoscopy in neonates, the French neonatal society issued best practice guidelines in January 2023 for premedication before laryngoscopy in neonates. These guidelines were published in an English peer-reviewed journal and presented in national conferences. However, the implementation of new premedication protocols in neonatal units can be made difficult due to local habits, poor dissemination of the guidelines and a limited level of evidence on some premedication agents. Thus, conducting a survey one year after issuing the best practice guidelines on premedication seems important to evaluate French premedication practices and to evaluate the impact and dissemination of the guidelines
Interventions
OTHERSurvey of sedo-analgesia practices before laryngoscopy
The survey will evaluate adequation to the French best practice guidelines to improve their dissemination and to identify current practices of premedication before laryngoscopy in neonates in French units (agents, dosing, efficacy, safety)
Sponsors
Centre Hospitalier Intercommunal Creteil
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Weeks to 44 Weeks
Healthy volunteers
No
Inclusion criteria
* Every neonate (corrected gestational age \< 45 weeks of gestation) that undergoes a laryngoscopy (for intubation or LISA) or a laryngeal mask insertion, that received a premedication or not during the 28 days of the survey.
Exclusion criteria
* Laryngoscopy or laryngeal mask insertion in the operating room * Opposition to data collection of a parent or holder of parental rights
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of patients who received a 1st sequence of sedo-analgesia consistent with best practice guidelines during laryngoscopy or laryngeal mask placement | Immediately after the laryngoscopy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cumulative doses of sedo-analgesia used | Immediately after the laryngoscopy | — |
| Questionnaire for the operator describing reasons for non-compliance with best practice guidelines | Immediately after the laryngoscopy | — |
| Molecules used for sedo-analgesia | Immediately after the laryngoscopy | — |
| TRACHEA score (Tonus, Reactivity, Awareness & Conditions of intubation to Help in Endotracheal intubation Assessment) | Immediately after the laryngoscopy | TRACHEA score from 0 to 10 where 0 represents adequate sedation with excellent conditions of intubation and 10 represents inadequate sedation with very poor conditions of intubation |
| Side effects related to the premedication | Immediately after the laryngoscopy | — |
| Numeric rating scale for pain (by operator and assistant) | Immediately after the laryngoscopy | — |
Countries
France
Outcome results
None listed