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Walter‐Nicolet E, Marchand‐Martin L, Guellec I, Biran V, Moktari M, Zana‐Taieb E, Magny J, Desfrère L, Waszak P, Boileau P, Chauvin G, Saint Blanquat L, Borrhomée S, Droutman S, Merhi M, Zupan V, Karoui L, Cimerman P, Carbajal R, Durrmeyer X. Premedication practices for neonatal tracheal intubation: Results from the EPIPPAIN 2 prospective cohort study and comparison with EPIPPAIN 1. Paediatric and Neo Pain 2021; 3:46-58. [PMID: 35547594 PMCID: PMC8975199 DOI: 10.1002/pne2.12048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/17/2021] [Accepted: 03/03/2021] [Indexed: 11/25/2022]
Abstract
To describe the frequency and nature of premedication practices for neonatal tracheal intubation (TI) in 2011; to identify independent risk factors for the absence of premedication; to compare data with those from 2005 and to confront observed practices with current recommendations. Data concerning TI performed in neonates during the first 14 days of their admission to participating neonatal/pediatric intensive care units were prospectively collected at the bedside. This study was part of the Epidemiology of Procedural Pain in Neonates study (EPIPPAIN 2) conducted in 16 tertiary care units in the region of Paris, France, in 2011. Multivariate analysis was used to identify factors associated with premedication use and multilevel analysis to identify center effect. Results were compared with those of the EPIPPAIN 1 study, conducted in 2005 with a similar design, and to a current guidance for the clinician for this procedure. One hundred and twenty‐one intubations carried out in 121 patients were analyzed. The specific premedication rate was 47% and drugs used included mainly propofol (26%), sufentanil (24%), and ketamine (12%). Three factors were associated with the use of a specific premedication: nonemergent TI (Odds ratio (OR) [95% CI]: 5.3 [1.49‐20.80]), existence of a specific written protocol in the ward (OR [95% CI]:4.80 [2.12‐11.57]), and the absence of a nonspecific concurrent analgesia infusion before TI (OR [95% CI]: 3.41 [1.46‐8.45]). No center effect was observed. The specific premedication rate was lower than the 56% rate observed in 2005. The drugs used were more homogenous and consistent with the current recommendations than in 2005, especially in centers with a specific written protocol. Premedication use prior to neonatal TI was low, even for nonemergent procedures. Scientific consensus, implementation of international or national recommendations, and local written protocols are urgently needed to improve premedication practices for neonatal intubation.
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Affiliation(s)
- Elizabeth Walter‐Nicolet
- Medicine and Neonatal Intensive Care Unit Saint Joseph Hospital Paris France
- INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center Obstetrical, Perinatal and Pediatric Epidemiology Team Paris France
| | - Laetitia Marchand‐Martin
- INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center Obstetrical, Perinatal and Pediatric Epidemiology Team Paris France
| | - Isabelle Guellec
- INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center Obstetrical, Perinatal and Pediatric Epidemiology Team Paris France
- Paediatric and Neonatal Intensive Care Unit, Trousseau Hospital Assistance Publique – Hôpitaux de Paris Paris France
- Medicine Sorbonne University Paris France
| | - Valérie Biran
- Neonatal Intensive Care Unit Assistance Publique – Hôpitaux de Paris CHU Robert Debré University Paris Diderot, Sorbonne Paris Cité Paris France
- Inserm U1141 University Paris Diderot, Sorbonne Paris Cité Paris France
| | - Mostafa Moktari
- Pediatric and Neonatal Intensive Care Unit Bicêtre Hospital Assistance Publique – Hôpitaux de Paris Paris France
- Espace Ethique/Ile de France ‐ Saint‐Louis Hospital Assistance Publique ‐Hôpitaux de Paris Paris France
| | - Elodie Zana‐Taieb
- Port‐Royal Maternity Neonatal Intensive Care Unit Cochin‐Port Royal Hospital Assistance Publique‐Hôpitaux de Paris Paris France
| | - Jean‐François Magny
- Neonatal Intensive Care Unit Necker‐Enfants Maladies Hospital Assistance Publique – Hôpitaux de Paris Paris France
| | - Luc Desfrère
- Neonatal Intensive Care Unit Louis Mourier Hospital Assistance Publique – Hôpitaux de Paris Paris France
| | - Paul Waszak
- Medicine and Neonatal Intensive Care Unit Delafontaine Hospital Saint Denis France
| | - Pascal Boileau
- Neonatal Intensive Care Unit Centre Hospitalier Intercommunal Poissy‐Saint Germain Poissy France
- Inserm U1185 Université Paris Saclay Le Kremlin‐Bicêtre France
| | - Gilles Chauvin
- Neonatal Intensive Care Unit Argenteuil Hospital Argenteuil France
| | - Laure Saint Blanquat
- Pediatric and Neonatal Intensive Care Unit Necker‐enfants Malades Hospital Assistance Publique – Hôpitaux de Paris Paris France
| | | | - Stéphanie Droutman
- Pediatric and Neonatal Intensive Care Unit Centre Hospitalier Intercommunal André Grégoire Montreuil France
| | - Mona Merhi
- Neonatal Intensive Care Unit Centre Hospitalier Sud Francilien Corbeil‐Essonnes France
| | - Véronique Zupan
- Neonatal Intensive Care Unit Antoine Béclère Hospital Assistance Publique – Hôpitaux de Paris Clamart France
| | - Leila Karoui
- Neonatal Intensive Care Unit, Grand hôpital de l’Est francilien, site de Meaux Meaux France
| | - Patricia Cimerman
- Centre National de Ressources de lutte contre la Douleur, Trousseau Hospital Assistance Publique – Hôpitaux de Paris Paris France
| | - Ricardo Carbajal
- INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center Obstetrical, Perinatal and Pediatric Epidemiology Team Paris France
- Medicine Sorbonne University Paris France
- Paediatric Emergency Department, Trousseau Hospital Assistance Publique – Hôpitaux de Paris Paris France
| | - Xavier Durrmeyer
- INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center Obstetrical, Perinatal and Pediatric Epidemiology Team Paris France
- Neonatal Intensive Care Unit Centre Hospitalier Intercommunal de Créteil University Paris Est Créteil Créteil France
- Faculté de Médecine de Créteil IMRB, GRC CARMAS Université Paris Est Créteil Créteil France
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Carbajal R, Courtois E, Droutman S, Magny J, Merchaoui Z, Durrmeyer X, Roussel C, Biran V, Eleni S, Renolleau S, Desfrere L, Todorova D, Boimond N, Mellah D, Bolot P, Coursol A, Vottier G, Brault D, Cimerman P. SFNP-16 - Epidémiologie des gestes douloureux et stressants en réanimation néonatale, Epippain2. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71889-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Esquivel-Walls E, Achour S, Droutman S, Rousset A, Daoud P. FC21.4 Video-EEG diagnosis of non-epileptic myoclonic events in new-borns. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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