Knowledge, behavior, and awareness of neonatologists and anesthesiologists about oral complications of intubation and protection methods

Abstract

Objectives: This study aimed to assess awareness of anesthesiologists and neonatologists about oral complications occurring during and after the orotracheal intubation (OTI) in premature infants and their knowledge and behavior regarding protection methods from these complications in clinical practice. Methods: This study included 94 neonatologists and 137 anesthesiologist. The final version of the questionnaire included 15 items in three main parts: (i) personal information; (ii) awareness about oral complications occurring during and after the OTI in premature infants; (iii) knowledge and behavior regarding protection methods from these complications in clinical practice. Results: A total of 95.7% of neonatologists and 83.2% of anesthesiologists were aware of oral complications related to OTI. The most common complications the anesthesiologists encountered were oral, laryngeal, or pharyngeal region injuries (60.7%) and palatal groove (52.2%) for the neonatologists. The most preferred method for stabilization of the orotracheal intubation tube (OTT) was bonding to the perioral region with an adhesive tape (98.3%). The primary determining factor in the choice of OTT stabilization method was the ease of use (28.2%). A total of 23.8% of the participants were aware of the palatal stabilization device (PSD), whereas only 1.3% used it in their routine and 57.1% of them believed it can prevent complications. Conclusions: The results showed that neonatologists were more aware of the OTI-related oral complications than anesthesiologists. The knowledge of the participants regarding prevention of these complications is insufficient. Study participants believe in the efficacy of PSD but do not use it in clinical practice for a number of reasons.

Intermittent hypoxia in neonatal rodents affects facial bone growth

“…Outcomes of several previous European studies suggest that individuals who experienced preterm birth tend to show malocclusions due to disharmonious facial growth [ 37 ]. Although controversial, many previous malocclusion studies were based on the assumption that life-supporting equipment maintained in the oral cavity of preterm infants is the principal causal contributor to malocclusions [ 38 , 39 ]. However, the findings here indicate that a more plausible pathophysiology for faulty facial bone development is impaired breathing, leading to IH that triggers exaggerated sympathetic outflow at an early age.…”

Indications, Measurements, and Complications of Ten Essential Neonatal Procedures

“…These complications resulted from malpositioning or displacement of the tube, tubal obstruction by thickened secretions, accidental tube extubation, and prolonged intubation. ETT-related complications can be either localized to the respiratory system or systemic complications [ 105 ]. They were classified into severe and nonsevere complications.…”