Abstract
Although first described in animals in mythologies and ancient civilizations (Raju 1999), neonatal endotracheal intubation was first recommended as resuscitation practice at birth in Parisian maternities at the beginning of the nineteenth century (Obladen 2009). Techniques and opinions relative to this practice dramatically evolved in the next years until it was finally considered as a life-saving practice for compromised newborns in the late 1920s and early 1930s. This procedure requires specific skills due to potentially life-threatening situation, small size of babies, and particular physiological status of newborns. This chapter will cover the specificities of neonatal intubation regarding its physiological effects, possible adverse effects, and recommended practice.
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References
Barrington KJ, Finer NN, Etches PC (1989) Succinylcholine and atropine for premedication of the newborn infant before nasotracheal intubation: a randomized, controlled trial. Crit Care Med 17(12):1293–1296
Bhutada A et al (2000) Randomised controlled trial of thiopental for intubation in neonates. Arch Dis Child Fetal Neonatal Ed 82(1):F34–F37
Carbajal R, Eble B, Anand KJ (2007) Premedication for tracheal intubation in neonates: confusion or controversy? Semin Perinatol 31(5):309–317
Charlton AJ, Greenhough SG (1988) Blood pressure response of neonates to tracheal intubation. Anaesthesia 43(9):744–746
Contencin P, Narcy P (1993) Size of endotracheal tube and neonatal acquired subglottic stenosis. Study group for neonatology and pediatric emergencies in the Parisian area. Arch Otolaryngol Head Neck Surg 119(8):815–819
Dempsey EM et al (2006) Facilitation of neonatal endotracheal intubation with mivacurium and fentanyl in the neonatal intensive care unit. Arch Dis Child Fetal Neonatal Ed 91(4):F279–F282
Derbyshire SW, Furedi A (1996) Do fetuses feel pain? “Fetal pain” is a misnomer. BMJ 313(7060):795
Donn SM, Philip AG (1978) Early increase in intracranial pressure in preterm infants. Pediatrics 61(6):904–907
Duncan HP, Zurick NJ, Wolf AR (2001) Should we reconsider awake neonatal intubation? A review of the evidence and treatment strategies. Paediatr Anaesth 11(2):135–145
Embleton ND et al (2001) Foot length, an accurate predictor of nasotracheal tube length in neonates. Arch Dis Child Fetal Neonatal Ed 85(1):F60–F64
Finer NN (2008) Nasal continuous positive airway pressure does not reduce rate of death or bronchopulmonary dysplasia in preterm infants. J Pediatr 153(1):145
Fisher DM, Frewen T, Swedlow DB (1982) Increase in intracranial pressure during suctioning–stimulation vs. Rise in PaCO2. Anesthesiology 57(5):416–417
Fitzgerald M, Millard C, MacIntosh N (1988) Hyperalgesia in premature infants. Lancet 1(8580):292
Friesen RH, Honda AT, Thieme RE (1987) Changes in anterior fontanel pressure in preterm neonates during tracheal intubation. Anesth Analg 66(9):874–878
Ghanta S et al (2007) Propofol compared with the morphine, atropine, and suxamethonium regimen as induction agents for neonatal endotracheal intubation: a randomized, controlled trial. Pediatrics 119(6):e1248–e1255
Kelly MA, Finer NN (1984) Nasotracheal intubation in the neonate: physiologic responses and effects of atropine and pancuronium. J Pediatr 105(2):303–309
Kempley ST, Moreiras JW, Petrone FL (2008) Endotracheal tube length for neonatal intubation. Resuscitation 77(3):369–373
Krause MF, Hoehn T (1998) Partial transsection of the neonatal trachea. Resuscitation 38(1):43–46
Kumar P, Denson SE, Mancuso TJ (2010) Premedication for nonemergency endotracheal intubation in the neonate. Pediatrics 125(3):608–615
Lemyre B et al (2004) Morphine for elective endotracheal intubation in neonates: a randomized trial [ISRCTN43546373]. BMC Pediatr 4:20
Lenclen R et al (2009) Evaluation of an educational intervention on the standard of neonatal resuscitation: orotracheal versus nasotracheal intubation. Arch Pediatr 16(4):337–342
Marshall TA et al (1984) Physiologic changes associated with endotracheal intubation in preterm infants. Crit Care Med 12(6):501–503
Milesi C et al (2006) Nitrous oxide analgesia for intubating preterm neonates: a pilot study. Acta Paediatr. 95(9):1104–1108
McDonald MM et al (1984) Timing and antecedents of intracranial hemorrhage in the newborn. Pediatrics 74(1):32–36
Millar C, Bissonnette B (1994) Awake intubation increases intracranial pressure without affecting cerebral blood flow velocity in infants. Can J Anaesth 41(4):281–287
Naumovski L, Schaffer K, Fleisher B (1991) Ingestion of a laryngoscope light bulb during delivery room resuscitation. Pediatrics 87(4):581–582
O’Donnell CP et al (2006) Endotracheal intubation attempts during neonatal resuscitation: success rates, duration, and adverse effects. Pediatrics 117(1):e16–e21
Obladen M (2009) History of neonatal resuscitation – part 3: endotracheal intubation. Neonatology 95(3):198–202
Oei J et al (2002) Facilitation of neonatal nasotracheal intubation with premedication: a randomized controlled trial. J Paediatr Child Health. 38(2):146–50
Papoff P et al (2008) Effectiveness and safety of propofol in newborn infants. Pediatrics 121(2):448; author reply 448–449
Patel R et al (1994) Age and the onset of desaturation in apnoeic children. Can J Anaesth 41(9):771–774
Pereira e Silva et al (2007) Morphine versus remifentanil for intubating preterm neonates. Arch Dis Child Fetal Neonatal Ed. 92(4): p. F293–294
Peterson J et al (2006) Accuracy of the 7-8-9 rule for endotracheal tube placement in the neonate. J Perinatol 26(6):333–336
Raju TN (1999) History of neonatal resuscitation. Tales of heroism and desperation. Clin Perinatol 26(3):629–640, vi–vii
Raju TN et al (1980) Intracranial pressure during intubation and anesthesia in infants. J Pediatr 96(5):860–862
Roberts WA et al (1995) The use of capnography for recognition of esophageal intubation in the neonatal intensive care unit. Pediatr Pulmonol 19(5):262–268
Roberts KD et al (2006) Premedication for nonemergent neonatal intubations: a randomized, controlled trial comparing atropine and fentanyl to atropine, fentanyl, and mivacurium. Pediatrics 118(4):1583–1591
Spence K, Barr P (2000) Nasal versus oral intubation for mechanical ventilation of newborn infants. Cochrane Database Syst Rev (2):CD000948
Stow PJ et al (1988) Anterior fontanelle pressure responses to tracheal intubation in the awake and anaesthetized infant. Br J Anaesth 60(2):167–170
Thayyil S et al (2008) Optimal endotracheal tube tip position in extremely premature infants. Am J Perinatol 25(1):13–16
The International Liaison Committee on Resuscitation (2006) The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: neonatal resuscitation. Pediatrics 117(5):e978–e988
Welzing L et al (2009) Remifentanil for INSURE in preterm infants: a pilot study for evaluation of efficacy and safety aspects. Acta Paediatr 98(9):1416–1420
Welzing L et al (2010) Propofol as an induction agent for endotracheal intubation can cause significant arterial hypotension in preterm neonates. Paediatr Anaesth 20(7):605–611
Whitelaw A (2001) Intraventricular haemorrhage and posthaemorrhagic hydrocephalus: pathogenesis, prevention and future interventions. Semin Neonatol 6(2):135–146
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Durrmeyer, X., Danan, C. (2015). Neonatal Intubation (Specific Considerations). In: Rimensberger, P. (eds) Pediatric and Neonatal Mechanical Ventilation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-01219-8_5
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DOI: https://doi.org/10.1007/978-3-642-01219-8_5
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