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- Title
Cerebral Oxygenation during Neonatal Intubation with Nasal High Flow: A Sub-Study of the SHINE Randomized Trial.
- Authors
Van Der Veeken, Ellyn; Manley, Brett James; Owen, Louise; Kamlin, Omar; Roberts, Calum; Newman, Sophie; Francis, Kate; Donath, Susan; Davis, Peter; Cuzzilla, Rocco; Hodgson, Kate Alison
- Abstract
Introduction: Nasal high flow (nHF) improves the likelihood of successful neonatal intubation on the first attempt without physiological instability. The effect of nHF on cerebral oxygenation is unknown. The aim of this study was to compare cerebral oxygenation during endotracheal intubation in neonates receiving nHF and those receiving standard care. Methods: A sub-study of a multicentre randomized trial of nHF during neonatal endotracheal intubation. A subset of infants had near-infrared spectroscopy (NIRS) monitoring. Eligible infants were randomly assigned to nHF or standard care during the first intubation attempt. NIRS sensors provided continuous regional cerebral oxygen saturation (rScO2) monitoring. The procedure was video recorded, and peripheral oxygen saturation and rScO2 data were extracted at 2-second intervals. The primary outcome was the average difference in rScO2 from baseline during the first intubation attempt. Secondary outcomes included average rScO2 and rate of change of rScO2. Results: Nineteen intubations were analyzed (11 nHF; 8 standard care). Median (interquartile range [IQR]) postmenstrual age was 27 (26.5–29) weeks, and weight was 828 (716–1,135) g. Median change in rScO2 from baseline was −1.5% (−5.3 to 0.0) in the nHF group and −9.4% (−19.6 to −4.5) in the standard care group. rScO2 fell more slowly in infants managed with nHF compared with standard care: median (IQR) rScO2 change −0.08 (−0.13 to 0.00) % per second and −0.36 (−0.66 to −0.22) % per second, respectively. Conclusions: In this small sub-study, regional cerebral oxygen saturation was more stable in neonates who received nHF during intubation compared with standard care.
- Subjects
OXYGEN in the blood; INTUBATION; OXYGEN saturation; TRACHEA intubation; NEAR infrared spectroscopy; ENDOTRACHEAL suctioning
- Publication
Neonatology (16617800), 2023, Vol 120, Issue 4, p458
- ISSN
1661-7800
- Publication type
Article
- DOI
10.1159/000529870