ArticleJournal of perinatology : official journal of the California Perinatal Association2026
Reducing tracheal intubation adverse events and severe desaturations by increasing intubation premedication use in infants <1500 g: a quality improvement initiative.
Article in Journal of perinatology : official journal of the California Perinatal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundTracheal intubation in very low birth weight (VLBW) infants is a high-risk procedure associated with tracheal intubation adverse events (TIAEs). Premedication for non-emergent intubations typically includes a vagolytic and analgesic agent. Rapid sequence intubation (RSI), defined as premedication with a vagolytic, analgesic, and paralytic agent, is used to enhance procedural safety and reduce complications. Premedication without paralysis was used for infants receiving surfactant with immediate extubation.
objectiveTo increase the use of premedication and RSI in VLBW infants and reduce adverse events.
methodsA QI initiative targeting VLBW infants at a level IV NICU undergoing non-emergent intubations. Interventions included forming a multidisciplinary team, education, and implementing an EHR-pathway with embedded orders.
resultsPremedication use increased from 25.7% to 93.4%, and RSI use from 14.6% to 77.3%. TIAEs decreased from 41.4% to 14.4%, and severe desaturations from 32% to 11.2%.
conclusionsStandardizing premedication practices, including RSI, can improve neonatal safety.
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