Variability of neonatal premedication practices for endotracheal intubation and LISA in the UK (NeoPRINT survey)

Abstract

ObjectiveThe NeoPRINT Survey was designed to assess premedication practices throughout UK NHS Trusts for both neonatal endotracheal intubation and less invasive surfactant administration (LISA). DesignAn online survey consisting of multiple choice and open answer questions covering preferences of premedication for endotracheal intubation and LISA was distributed over a 67-day period. Responses were then analysed using STATA IC 16.0. SettingOnline survey distributed to all UK Neonatal Units (NNUs). ParticipantsThe survey evaluated premedication practices for endotracheal intubation and LISA in neonates requiring these procedures. Main outcome measuresThe use of different premedication categories as well as individual medications within each category was analysed to create a picture of typical clinical practice across the UK. ResultsThe response rate for the survey was 40.8 % (78/191). Premedication was used in all hospitals for endotracheal intubation but overall, 50 % (39/78) of the units that have responded, use premedications for LISA. Individual clinician preference had an impact on premedication practices within each NNU. ConclusionThe wide variability on first-line premedication for endotracheal intubation noted in this survey could be overcome using best available evidence through consensus guidance driven by organisations such as British Association of Perinatal |Medicine (BAPM). Secondly, the divisive view around LISA premedication practices noted in this survey requires an answer through a randomised controlled trial.