Pediatric Rapid Sequence Intubation

Fastle, Rebecca K.; Roback, Mark G.

doi:10.1097/01.pec.0000142947.35394.81

Cited by 59 publications

(28 citation statements)

References 10 publications

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“…More recent in-hospital literature involves larger case series of critically ill neonates, infants, and children undergoing emergency intubation 33 – 35 …”

Section: Prearrest Care Updatesmentioning

confidence: 99%

See 1 more Smart Citation

Part 12: Pediatric Advanced Life Support

Caen¹,

Berg²,

Chameides³

et al. 2015

Circulation

433

188

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“…More recent in-hospital literature involves larger case series of critically ill neonates, infants, and children undergoing emergency intubation 33 – 35 …”

Section: Prearrest Care Updatesmentioning

confidence: 99%

“…Observational data suggest that it increases the likelihood of survival to ICU discharge in children older than 28 days 33 . Evidence is conflicting as to whether preintubation atropine administration reduces the incidence of arrhythmias or postintubation shock 34 , 35 …”

Section: Prearrest Care Updatesmentioning

confidence: 99%

Part 12: Pediatric Advanced Life Support

Caen¹,

Berg²,

Chameides³

et al. 2015

Circulation

433

188

View full text Add to dashboard Cite

“…For example, the ant-cholinergic agents including atropine could prevent the occurrence of reflex bradycardia of endotracheal intubation and help to keep the mouth and nasal mucosa dry. [910] Other categories are benzodiazepines, which are in the sedative drugs, and the typical drug is midazolam. Today, they are used less frequently because of the detrimental effects of benzyl alcohol as a pharmaceutical excipients.…”

Section: Introductionmentioning

confidence: 99%

Remifentanil for endotracheal intubation in premature infants: A randomized controlled trial

2013

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Objective:Endotracheal intubation is a common procedure in neonatal care. The objective of this study was to determine whether the premedication with remifentanil before intubation has analgesic effects in newborn infants.Methods:A total of 40 premature infants who needed endotracheal intubation for intubation-surfactant-extubation method were randomly assigned in two groups of an equal number at two university hospitals. The control group was given 10 μg/kg atropine IV infusions in 1 min and then 2 ml normal saline. In the case group, the atropine was given with the same method and then remifentanil was administered 2 μg/kg IV infusions in 2 min.Findings:For remifentanil and control groups, the mean birth weight were 1761 ± 64 and 1447 ± 63 grams (P = 0.29), and the mean gestational ages were 31.69 ± 3.5 and 30.56 ± 2.8 weeks (P = 0.28), respectively. Using premature infant pain profile score, infants who received remifentanil felt significantly less pain than the control group (15.1 ± 1.6 vs. 7.5 ± 1.4; P < 0.001). There were no significant differences in the duration of endotracheal intubation procedure (20.8 ± 6 vs. 22.8 ± 7.3 s; P = 0.33), the number of attempts for successful intubation and oxygen desaturation between groups.Conclusion:Premedication with remifentanil has good analgesic effects for endotracheal intubation in premature infants without significant derangements in mean blood pressure and oxygen saturation.

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“…A strong vagal reflex is more commonly seen in the pediatric population which has implemented the use of atropine as a premedication [5]. The belief is that during laryngoscopy, an arrest of the sinoatrial node occurs with a simultaneous impulse via the atrioventricular node leading to bradycardia and asystole.…”

Section: Discussionmentioning

confidence: 99%

Asystole following Reintubation during Suspension Laryngoscopy

Glassman

Green

Brodsky

2012

Case Reports in Anesthesiology

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Transient increase in heart rate and mean arterial pressure commonly occur during manipulation of the airway via direct laryngoscopy. This phenomenon is understood to be due to a sympathetic nervous system reflex causing an increase in plasma catecholamines. Rarely, severe bradycardia and possible asystole can occur following laryngoscopy. One previous report described asystole during suspension laryngoscopy after uneventful direct laryngoscopy. Here we report a case of asystole occurring at the time of reinsertion and cuff inflation of an endotracheal tube in a patient who had been hemodynamically stable during initial direct laryngoscopy and the ensuing suspension laryngoscopy. The asystole was immediately recognized and successful cardiopulmonary resuscitation was performed with the patient returning to baseline sinus rhythm. Cardiac arrest following laryngoscopy is rare. This case highlights the importance of continued vigilance even after the initial manipulations of the airway by both direct laryngoscopy and suspension laryngoscopy are to be performed. Identifying patients who may benefit from premedication with a vagolytic drug may prevent adversity. Preoperative heart rate analysis can identify patients with strong vagal tone.

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Pediatric Rapid Sequence Intubation

Cited by 59 publications

References 10 publications

Part 12: Pediatric Advanced Life Support

Part 12: Pediatric Advanced Life Support

Remifentanil for endotracheal intubation in premature infants: A randomized controlled trial

Asystole following Reintubation during Suspension Laryngoscopy

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