ArticleNeonatology2021
Impact of Physician Training Level on Neonatal Tracheal Intubation Success Rates and Adverse Events: A Report from National Emergency Airway Registry for Neonates (NEAR4NEOS).
Article in Neonatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 9. Neonatal resuscitation.Clinical and experimental emergency medicine · 2026Guideline
- Respiratory Stabilization for Successful Intubation in Neonates: A Randomized Controlled Trial.Indian pediatrics · 2026Trial
- Nasal high-flow therapy to Optimise Stability during Intubation: the NOSI pilot trial.Archives of disease in childhood. Fetal and neonatal edition · 2023Trial
- Association of atropine use during neonatal intubation with cardiac arrest, severe bradycardia, and other adverse events: a report from NEAR4NEOS.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- EBNEO Commentary: Impact of Attending Neonatologist Presence on Neonatal Intubation Success and Adverse Events: A Cohort Study.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- Pragmatic Respiratory Stabilization During Neonatal Intubation-What Does this Trial Add for Indian NICUs?Indian pediatrics · 2026Article
- Impact of attending neonatologist presence on neonatal intubation success and adverse events: a cohort study.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Reducing tracheal intubation adverse events and severe desaturations by increasing intubation premedication use in infants <1500 g: a quality improvement initiative.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Flow disruptions during delivery room intubation of neonates with congenital diaphragmatic hernia.Resuscitation · 2025Observational
- Impact of attending neonatologist presence on neonatal intubation success and adverse events: a cohort study.Research square · 2025Article
- Success and safety of neonatal endotracheal tube exchanges: a NEAR4NEOS multicentre retrospective cohort study.Archives of disease in childhood. Fetal and neonatal edition · 2025Observational
- Article
- Neonatal Tracheal Intubation in the NICU: A Literature Review.Healthcare (Basel, Switzerland) · 2025Review
- Video vs. traditional laryngoscopy for tracheal intubation at birth or in the neonatal unit: A systematic review and meta-analysis.Resuscitation plus · 2025Review
- Review
- Ventilation practices and preparedness of healthcare providers in term newborn resuscitation: A comprehensive survey study in Austrian hospitals.Resuscitation plus · 2024Article
- Factors that impact second attempt success for neonatal intubation following first attempt failure: a report from the National Emergency Airway Registry for Neonates.Archives of disease in childhood. Fetal and neonatal edition · 2024Article
- [Airway management in neonates and infants : Recommendations according to the ESAIC/BJA guidelines].Die Anaesthesiologie · 2024Article
- Factors that determine first intubation attempt success in high-risk neonates.Pediatric research · 2024Article
- Bedside critical care training: A quasi-experimental study in the paediatric emergency department of a referral hospital in Nigeria.The Southern African journal of critical care : the official journal of the Critical Care Society · 2024Article
Corrections and comments
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Authors and funding
16 authors at 11 institutions in 3 countries.
Funding
Abstract
introductionNeonatal tracheal intubation (TI) outcomes have been assessed by role, but training level may impact TI success and safety. Effect of physician training level (PTL) on the first-attempt success, adverse TI-associated events (TIAEs), and oxygen desaturation was assessed.
methodsProspective cohort study in 11 international NEAR4NEOS sites between October 2014 and December 2017. Primary TIs performed by pediatric/neonatal physicians were included. Univariable analysis evaluated association between PTL, patient/practice characteristics, and outcomes. Multivariable analysis with generalized estimating equation assessed for independent association between PTL and outcomes (first-attempt success, TIAEs, and oxygen desaturation ≥20%; attending as reference).
resultsOf 2,608 primary TIs, 1,298 were first attempted by pediatric/neonatal physicians. PTL was associated with patient age, weight, comorbidities, TI indication, difficult airway history, premedication, and device. First-attempt success rate differed across PTL (resident 23%, fellow 53%, and attending 60%; p < 0.001). There was no statistically significant difference in TIAEs (resident 22%, fellow 20%, and attending 25%; p = 0.34). Desaturation occurred more frequently with residents (60%), compared to fellows and attendings (46 and 53%; p < 0.001). In multivariable analysis, adjusted odds ratio of the first-attempt success was 0.18 (95% CI: 0.11-0.30) for residents and 0.80 (95% CI: 0.51-1.24) for fellows. PTL was not independently associated with adjusted odds of TIAEs or severe oxygen desaturation.
conclusionHigher PTL was associated with increased first-attempt success but not TIAE/oxygen desaturation. Identifying strategies to decrease adverse events during neonatal TI remains critical.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.