Decreasing neonatal intubation rates: Trends at a community hospital

Abstract

BackgroundEndotracheal intubation (ETI) is a technically complex skill, critical in resuscitation of the neonatal patient. Decreasing rates of ETI have been noted in several patient populations, requiring providers to seek additional training to maintain proficiency. Previous work has been conducted in large academic centers, but little is know about ETI in the neonatal population in smaller community hospitals, where a substantial amount of neonatal care is provided. ObjectivesWe sought to identify intubation rates over time in the community neonatal intensive care unit (NICU) setting. MethodsWe performed a retrospective analysis of a prospectively collected database on neonatal intubations from January 1, 2010 through December 31, 2014. We identified patient and intubation characteristics and calculated the rate of intubation per number of NICU admissions per year. The change in ETI rates was analyzed using the X2 test for trend. ResultsOver the 5-year period, NICU staff performed ETI on 255 patients. The study population was 37% female and had a mean gestational age of 33 weeks. African American patients made up 13% of the study population, 6% were Hispanic, 78% were Caucasian, and 3% were other races. Annual intubation rates declined over the course of the study: 32% in 2010, 28% in 2011, 25% in 2012, 22% in 2013, and 16% in 2014 (p < 0.01). ConclusionNICU ETI rates in the community setting have decreased from 2010 to 2014. As the landscape of neonatal intubation changes, it will be vital to maintain practitioners' intubation skill-set through other methods.