Journal article
Reducing Intubations and Related Risks in Neonates with Retinopathy of Prematurity Undergoing Laser Photocoagulation
Pediatric quality & safety, v 10(1), e780
Jan 2025
PMID: 39734909
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Although associated with respiratory morbidity, elective endotracheal intubation (ETI) for laser photocoagulation for retinopathy of prematurity (ROP) is the standard practice at our institution, with 100% of patients undergoing preoperation ETI. To mitigate this risk, we strove to reduce the percentage of infants intubated for laser photocoagulation by 30% by June 2022.
We assembled a multidisciplinary team and implemented a deep sedation guideline utilizing dexmedetomidine, fentanyl, and midazolam with noninvasive ventilation support for laser photocoagulation in January 2020. Outcome, process, and balancing measures tracked the efficacy and safety of the quality improvement project.
We reduced the percentage of infants requiring intubation for laser photocoagulation from 100% (8/8) to 10% (1/10). We reduced the average time to return to baseline respiratory status from 224.1 to 33.8 hours (9.3d to1.4 d). Cardiorespiratory index scores slightly increased (1 to 1.2), and pain scores remained unchanged after interventions.
A multidisciplinary team approach using a deep sedation guideline and noninvasive ventilation can safely reduce the requirement for intubation during laser photocoagulation with a faster return to baseline respiratory status.
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Details
- Title
- Reducing Intubations and Related Risks in Neonates with Retinopathy of Prematurity Undergoing Laser Photocoagulation
- Creators
- Vilmaris Quinones Cardona - Drexel UniversityEmma McNell Byrne - Drexel UniversityNovisi Arthur - St. Christopher's Hospital for ChildrenMegan Young - Drexel UniversityDiane Lavery - Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PaAmanda Carroll - St. Christopher's Hospital for ChildrenSwosti Joshi - St. Christopher's Hospital for ChildrenFolasade Kehinde - Drexel UniversityOgechukwu Menkiti - Drexel University
- Publication Details
- Pediatric quality & safety, v 10(1), e780
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:001386466100001
- Scopus ID
- 2-s2.0-85213887049
- Other Identifier
- 991022008797604721
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- Web of Science research areas
- Pediatrics