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Dempsey T, Nguyen HT, Nguyen HL, Bui XA, Pham PTT, Nguyen TK, Helldén D, Cavallin F, Trevisanuto D, Höök SM, Blennow M, Olson L, Vu H, Nguyen AD, Alfvén T, Pejovic N. Endotracheal intubation performance at a large obstetric hospital delivery room, Hanoi, Vietnam. Resusc Plus 2022; 12:100338. [PMID: 36482918 PMCID: PMC9723915 DOI: 10.1016/j.resplu.2022.100338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/12/2022] [Accepted: 11/16/2022] [Indexed: 12/10/2022] Open
Abstract
INTRODUCTION Intrapartum-related events account for nearly 700,000 neonatal deaths globally yearly. Endotracheal intubation is a cornerstone in preventing many of these deaths, but it is a difficult skill to acquire. Previous studies have described intubation performances in high-income countries, but data from low- and middle-income countries are lacking. We aimed to assess the performance of delivery room intubation in a lower middle-income country. METHODS This prospective observational study was conducted at the Phu San Hanoi Hospital, Vietnam, from September 2020 to January 2021. Video cameras were positioned above the resuscitation tables and data were extracted using adopted software (NeoTapAS). All neonates requiring positive pressure ventilation were included. Our main variables of interest were time to first intubation attempt, first intubation attempt duration, and successful first intubation attempt. RESULTS 18,107 neonates were born during the five months. Of these, 75 (0.4%) received positive pressure ventilation, and 36 (0.2%) required endotracheal intubation of whom 24 were captured on video. The median time to the first intubation attempt was 252 seconds (range 91-771 seconds), the median first attempt duration was 49 seconds (range 10-105 seconds), and the first attempt success rate was 75%. CONCLUSION Incidences of positive pressure ventilation and endotracheal intubation were low in comparison to global estimates. Three out of four intubations were successful at the first attempt and the procedural duration was often longer than recommended. Future studies should focus on how to achieve and maintain intubation skills and could include considering alternative devices for airway management at birth.
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Affiliation(s)
- Tina Dempsey
- Department of Global Public Health, Karolinska Institutet, 17177 Solna, Sweden,Astrid Lindgren Children’s Hospital, Karolinska University Hospital, 17176 Solna, Sweden,Corresponding author at: Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, 17177 Solna, Sweden.
| | - Huong Thu Nguyen
- Neonatal Department, Phu San Hanoi Hospital, Hanoi 100000, Viet Nam
| | | | - Xuan Anh Bui
- Department of Information Technology, Phu San Hanoi Hospital, Hanoi 100000, Viet Nam
| | | | - Toan K Nguyen
- Department of Gynecological Oncology, Phu San Hanoi Hospital, Hanoi 100000, Viet Nam,Department of International Collaboration, Phu San Hanoi Hospital, Hanoi 100000, Viet Nam
| | - Daniel Helldén
- Department of Global Public Health, Karolinska Institutet, 17177 Solna, Sweden
| | | | - Daniele Trevisanuto
- Department of Woman’s and Child’s Health, University Hospital of Padova, 35128 Padova, Italy
| | - Susanna Myrnerts Höök
- Department of Global Public Health, Karolinska Institutet, 17177 Solna, Sweden,Emergency Care Unit, Sachs’ Children and Youth Hospital, 11883 Stockholm, Sweden
| | - Mats Blennow
- Department of Clinical Science Intervention and Technology, Karolinska Institutet, 14152 Huddinge, Sweden
| | - Linus Olson
- Department of Global Public Health, Karolinska Institutet, 17177 Solna, Sweden,Department of Women’s and Children’s Health, Karolinska Institutet, 17177 Solna, Sweden,Department of Medical Biochemistry and Microbiology, Uppsala University, 75237 Uppsala, Sweden
| | - Hien Vu
- Department of International Collaboration, Phu San Hanoi Hospital, Hanoi 100000, Viet Nam,Intensive Care Unit and Poison Control Department, Phu San Hanoi Hospital, Hanoi 100000, Viet Nam,Social Work Department, Phu San Hanoi Hospital, Hanoi 100000, Viet Nam,University of Medicine and Pharmacy, Hanoi 100000, Viet Nam
| | - Anh Duy Nguyen
- University of Medicine and Pharmacy, Hanoi 100000, Viet Nam,Board of Directors, Phu San Hanoi Hospital, Hanoi 100000, Viet Nam
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, 17177 Solna, Sweden,Emergency Care Unit, Sachs’ Children and Youth Hospital, 11883 Stockholm, Sweden
| | - Nicolas Pejovic
- Department of Global Public Health, Karolinska Institutet, 17177 Solna, Sweden,Neonatal Unit, Sachs’ Children and Youth Hospital, 11883 Stockholm, Sweden
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Ilyes SG, Chiriac VD, Gluhovschi A, Mihaela V, Dahma G, Mocanu AG, Neamtu R, Silaghi C, Radu D, Bernad E, Craina M. The Influence of Maternal Factors on Neonatal Intensive Care Unit Admission and In-Hospital Mortality in Premature Newborns from Western Romania: A Population-Based Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060709. [PMID: 35743972 PMCID: PMC9229487 DOI: 10.3390/medicina58060709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/21/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Neonatal mortality is a global public health issue, disproportionately affecting low- and middle-income nations. Although Romania is a high-income nation, according to the European Union’s most recent demographic data, it had the second-highest infant death rate in 2019. Although significant progress has been made in the last three decades in lowering newborn mortality, more initiatives to accelerate progress are required to meet the 2030 Sustainable Development Goals (SDG) objective. Therefore, we aimed to develop an observational study to determine the influence of maternal factors on in-hospital neonatal intensive care unit admission and mortality in premature infants born in western Romania. While newborn mortality has decreased globally, the pace of decline is far less than what is desired. Materials and Methods: A retrospective study comprising 328 premature patients and 422 full-term newborns, was developed at a tertiary obstetrics and gynecology clinic in western Romania, comprising the period of the last 24 months before the COVID-19 pandemic and the first 24 months of the pandemic. Results: The following variables were identified as statistically significant risk factors for neonatal intensive care unit admission: age > 35 years, OR = 1.59; twin births, OR = 1.14; low gestational age, OR = 1.66; preeclampsia, OR = 2.33; and peripartum infection, OR = 2.25. The same risk factors, with the exception of twin births, were significantly associated with in-hospital neonatal mortality. Except for a longer duration of maternal hospitalization and neonatal therapy with surfactant, steroids, and antibiotics, the COVID-19 pandemic did not cause significant differences in the evolution and outcomes of preterm newborns. Conclusions: The major maternal risk factors for NICU admission were advanced age, twin pregnancy, low gestational age, preeclampsia, and peripartum infection. Additionally, these characteristics contributed to a high likelihood of death, despite adequate access to medical care and advanced life support for the neonates. Understanding the causes of morbidity and death in neonates admitted to the neonatal intensive care unit enables better prioritization and planning of health services, resource reallocation, and care quality improvement.
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Affiliation(s)
- Stelian-Gabriel Ilyes
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Veronica Daniela Chiriac
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
- Correspondence: ; Tel.: +40-729-098-886
| | - Adrian Gluhovschi
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Valcovici Mihaela
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - George Dahma
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Adelina Geanina Mocanu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Carmen Silaghi
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Daniela Radu
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Elena Bernad
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (S.-G.I.); (A.G.); (G.D.); (A.G.M.); (R.N.); (C.S.); (E.B.); (M.C.)
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