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Respiratory Therapist Intubation Practice in Pediatric ICUs: A Multicenter Registry Study.

Publication ,  Journal Article
Miller, AG; Napolitano, N; Turner, DA; Rehder, KJ; Nishisaki, A ...
Published in: Respiratory care
October 2020

Tracheal intubation by respiratory therapists (RTs) is a well-established practice that has been described primarily in adult and neonatal patients. However, minimal data exist regarding RTs' intubation performance in pediatric ICUs. The purpose of this study was to describe the current landscape of intubations performed by RTs in pediatric ICUs.A multicenter quality improvement database, the National Emergency Airway Registry for Children (NEAR4KIDS) was queried from 2015 to 2018. We performed a retrospective analysis of prospectively collected data on subject demographics, indication for intubation, difficult airway history and feature presence, provider discipline, medications, and device. Intubation outcomes included first-attempt and overall success rates, adverse events, and oxygen desaturation (ie, [Formula: see text] < 80%). Overall intubation success was defined as intubation achieved in ≤ 2 attempts.There were 12,056 initial intubation encounters from 46 ICUs, with 109 (0.9%) first attempts performed by RTs. Nine (20%) ICUs reported at least one intubation encounter by RTs. The number of intubations performed by RTs at individual centers ranged from 1 to 46 (RT participation rate: 0.3% to 19.6%). RTs utilized video laryngoscopy more often than other providers (53.2% for RTs vs 28.1% for others, P < .001). RTs' first attempt success (RT 60.6% vs other 69.2%, P = .051), overall success (RT 76.2 % vs other 82.4%, P = .09), and oxygen desaturation [Formula: see text] < 80% (RT 16.5% vs other 16.9%, P = .91) were similar to other providers. Adverse events were more commonly reported in intubations by RTs versus by other providers (22.9% vs 13.8%, P = .006).RTs infrequently intubate in pediatric ICUs, with success rates similar to other providers but higher adverse event rates. RTs were more likely to use video laryngoscopy than other providers. RTs' intubation participation, success, and adverse event rates varied greatly across pediatric ICUs.

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Published In

Respiratory care

DOI

EISSN

1943-3654

ISSN

0020-1324

Publication Date

October 2020

Volume

65

Issue

10

Start / End Page

1534 / 1540

Related Subject Headings

  • Retrospective Studies
  • Respiratory System
  • Registries
  • Laryngoscopy
  • Intubation, Intratracheal
  • Intensive Care Units, Pediatric
  • Humans
  • Child
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Miller, A. G., Napolitano, N., Turner, D. A., Rehder, K. J., Nishisaki, A., & National Emergency Airway Registry for Children (NEAR4KIDS) Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI), . (2020). Respiratory Therapist Intubation Practice in Pediatric ICUs: A Multicenter Registry Study. Respiratory Care, 65(10), 1534–1540. https://doi.org/10.4187/respcare.07667
Miller, Andrew G., Natalie Napolitano, David A. Turner, Kyle J. Rehder, Akira Nishisaki, and Akira National Emergency Airway Registry for Children (NEAR4KIDS) Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI). “Respiratory Therapist Intubation Practice in Pediatric ICUs: A Multicenter Registry Study.Respiratory Care 65, no. 10 (October 2020): 1534–40. https://doi.org/10.4187/respcare.07667.
Miller AG, Napolitano N, Turner DA, Rehder KJ, Nishisaki A, National Emergency Airway Registry for Children (NEAR4KIDS) Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI). Respiratory Therapist Intubation Practice in Pediatric ICUs: A Multicenter Registry Study. Respiratory care. 2020 Oct;65(10):1534–40.
Miller, Andrew G., et al. “Respiratory Therapist Intubation Practice in Pediatric ICUs: A Multicenter Registry Study.Respiratory Care, vol. 65, no. 10, Oct. 2020, pp. 1534–40. Epmc, doi:10.4187/respcare.07667.
Miller AG, Napolitano N, Turner DA, Rehder KJ, Nishisaki A, National Emergency Airway Registry for Children (NEAR4KIDS) Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI). Respiratory Therapist Intubation Practice in Pediatric ICUs: A Multicenter Registry Study. Respiratory care. 2020 Oct;65(10):1534–1540.

Published In

Respiratory care

DOI

EISSN

1943-3654

ISSN

0020-1324

Publication Date

October 2020

Volume

65

Issue

10

Start / End Page

1534 / 1540

Related Subject Headings

  • Retrospective Studies
  • Respiratory System
  • Registries
  • Laryngoscopy
  • Intubation, Intratracheal
  • Intensive Care Units, Pediatric
  • Humans
  • Child
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology