Pediatric anesthesia & critical care
Comparison of the Outcomes of Oral Versus Nasal Endotracheal Intubation in Neonates and Infants Undergoing Cardiac Surgery: A Randomized Controlled Study
Authors' conclusion
The nasal route for intubation is associated with less postoperative fentanyl consumption, earlier extubation, lower incidence of accidental extubation, and earlier full oral feeding than oral intubation. The nasal route is not associated with an increased risk of postoperative pneumonia or surgical wound infection.
Study context
- Population
- Neonates and infants undergoing open cardiac surgery
- Participants
- 220 neonates
- Comparison
- Nasal vs oral endotracheal intubation
- Primary endpoint
- Postoperative fentanyl consumption (µg/kg/h) by intubated patients
Methodological detailsopen-label, single-centre (university hospital)
- Open-label
- Single-centre (university hospital)
Primary result
As reported in the abstract
P < 0.001
Secondary outcomes
Time needed for intubation · significantly longer in nasal group
P < 0.001
Time to extubation · significantly shorter in nasal group
P < 0.05
ICU LOS · significantly shorter in nasal group
P < 0.05
Time to onset of full oral feeding · significantly shorter in nasal group
P = 0.031
Mean, beats/min
| Outcome | Oral | Nasal | P value |
|---|---|---|---|
| Increase in HR from baseline during intubationSignificantly lower in nasal group | 26 (SD 7) | 18 (SD 5) | P < 0.001 |
Hospital LOS
- No significant difference between oral and nasal groups
Safety
Inadvertent intraoperative extubation · significantly higher in oral group
P = 0.029
Reintubation, postintubation stridor, pneumonia, surgical wound infection
- No significant differences between oral and nasal groups
Original publication
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