{"id":26063,"date":"2024-07-23T04:39:00","date_gmt":"2024-07-22T20:39:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=26063"},"modified":"2024-07-23T06:02:20","modified_gmt":"2024-07-22T22:02:20","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e8%a7%86%e9%a2%91%e5%96%89%e9%95%9c%e4%b8%8e%e7%9b%b4%e6%8e%a5%e5%96%89%e9%95%9c%e8%bf%9b%e8%a1%8c%e6%96%b0%e7%94%9f%e5%84%bf%e7%b4%a7%e6%80%a5","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=26063","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u89c6\u9891\u5589\u955c\u4e0e\u76f4\u63a5\u5589\u955c\u8fdb\u884c\u65b0\u751f\u513f\u7d27\u6025\u63d2\u7ba1"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Video versus Direct Laryngoscopy for Urgent Intubation of Newborn Infants<\/h1>\n\n\n\n

Lucy E.\u00a0Geraghty,\u00a0Emma A.\u00a0Dunne,\u00a0Caitr\u00edona M.\u00a0N\u00ed Chathasaigh,\u00a0et al<\/h3>\n\n\n\n

N Engl J Med Published\u00a0May 5, 2024<\/h3>\n\n\n\n

DOI: 10.1056\/NEJMoa2402785<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h3>\n\n\n\n

Repeated attempts at endotracheal intubation are associated with increased adverse events in neonates. When clinicians view the airway directly with a laryngoscope, fewer than half of first attempts are successful. The use of a video laryngoscope, which has a camera at the tip of the blade that displays a view of the airway on a screen, has been associated with a greater percentage of successful intubations on the first attempt than the use of direct laryngoscopy in adults and children. The effect of video laryngoscopy among neonates is uncertain.<\/p>\n\n\n\n

METHODS<\/h3>\n\n\n\n

In this single-center trial, we randomly assigned neonates of any gestational age who were undergoing intubation in the delivery room or neonatal intensive care unit (NICU) to the video-laryngoscopy group or the direct-laryngoscopy group. Randomization was stratified according to gestational age (<32 weeks or \u226532 weeks). The primary outcome was successful intubation on the first attempt, as determined by exhaled carbon dioxide detection.<\/p>\n\n\n\n

RESULTS<\/h3>\n\n\n\n

Data were analyzed for 214 of the 226 neonates who were enrolled in the trial, 63 (29%) of whom were intubated in the delivery room and 151 (71%) in the NICU. Successful intubation on the first attempt occurred in 79 of the 107 patients (74%; 95% confidence interval [CI], 66 to 82) in the video-laryngoscopy group and in 48 of the 107 patients (45%; 95% CI, 35 to 54) in the direct-laryngoscopy group (P<0.001). The median number of attempts to achieve successful intubation was 1 (95% CI, 1 to 1) in the video-laryngoscopy group and 2 (95% CI, 1 to 2) in the direct-laryngoscopy group. The median lowest oxygen saturation during intubation was 74% (95% CI, 65 to 78) in the video-laryngoscopy group and 68% (95% CI, 62 to 74) in the direct-laryngoscopy group; the lowest heart rate was 153 beats per minute (95% CI, 148 to 158) and 148 (95% CI, 140 to 156), respectively.<\/p>\n\n\n\n

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CONCLUSIONS<\/h3>\n\n\n\n

Among neonates undergoing urgent endotracheal intubation, video laryngoscopy resulted in a greater number of successful intubations on the first attempt than direct laryngoscopy. (Funded by the National Maternity Hospital Foundation; VODE ClinicalTrials.gov number, NCT04994652<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Video versus Direct Laryngoscopy for U […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26063"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=26063"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26063\/revisions"}],"predecessor-version":[{"id":26064,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26063\/revisions\/26064"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26063"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26063"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26063"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}