Assessing the Impact of Nasotracheal Intubation on Postoperative Neonates With Congenital Heart Disease: A Quality Improvement Project at a Single Heart Center
OBJECTIVES:
Nasotracheal intubation (NTI) is associated with fewer unplanned extubations and improved oral motor skills compared with orotracheal intubation (OTI). Our study aimed to implement a practice change from OTI to NTI for neonatal cardiac surgery and assess impact on postoperative outcomes.
DESIGN:
Single-center, prospective, quality improvement study.
SETTING:
Academic children’s hospital.
PATIENTS:
One hundred thirty neonates undergoing cardiac surgery with cardiopulmonary bypass.
INTERVENTIONS:
NTI during index cardiac surgery.
MEASUREMENTS AND MAIN RESULTS:
Data were collected between January 2019 and April 2021. The study was implemented in three phases: retrospective: OTI neonates (n = 43), I: safety and feasibility of NTI (n = 17), and II: speech language pathology (SLP) evaluation on postoperative day 1 facilitated by NTI (n = 70). Retrospective and phase I patients were combined for analysis. Groups were compared using Kruskal-Wallis test or Wilcoxon rank-sum test.
Ninety-one percent of eligible neonates were nasotracheally intubated. There were no clinically significant complications. Days to first SLP encounter decreased from a median 4.5 days (interquartile range [IQR], 3.8–6.2) to 1.1 days (IQR, 1.0–1.9; p
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research
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