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This study is a national prospective survey on practices of premedication before laryngoscopy in neonates. The survey will evaluate adequation to the French best practice guidelines to improve their dissemination and to identify current practices of premedication before laryngoscopy in neonates in French units (agents, dosing, efficacy, safety)
Laryngoscopy for intubation or less invasive surfactant administration (LISA) in neonates is a stressful and painful procedure that necessitates a sedo-analgesia except in the case of an immediate life-threatening emergency. Nevertheless, there are discrepancies in premedication practices amongst neonatal units. In order to optimize analgesia before laryngoscopy in neonates, the French neonatal society issued best practice guidelines in January 2023 for premedication before laryngoscopy in neonates. These guidelines were published in an English peer-reviewed journal and presented in national conferences. However, the implementation of new premedication protocols in neonatal units can be made difficult due to local habits, poor dissemination of the guidelines and a limited level of evidence on some premedication agents. Thus, conducting a survey one year after issuing the best practice guidelines on premedication seems important to evaluate French premedication practices and to evaluate the impact and dissemination of the guidelines
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Survey of sedo-analgesia practices before laryngoscopy | Other | The survey will evaluate adequation to the French best practice guidelines to improve their dissemination and to identify current practices of premedication before laryngoscopy in neonates in French units (agents, dosing, efficacy, safety) |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients who received a 1st sequence of sedo-analgesia consistent with best practice guidelines during laryngoscopy or laryngeal mask placement | Immediately after the laryngoscopy |
| Measure | Description | Time Frame |
|---|---|---|
| Molecules used for sedo-analgesia | Immediately after the laryngoscopy | |
| Cumulative doses of sedo-analgesia used | Immediately after the laryngoscopy | |
| Questionnaire for the operator describing reasons for non-compliance with best practice guidelines |
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Inclusion Criteria:
Exclusion Criteria:
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Every neonate (corrected gestational age < 45 weeks of gestation) that undergoes a laryngoscopy (for intubation or LISA) or a laryngeal mask insertion, that received a premedication or not during the 28 days of the survey.
The survey will be proposed to all French neonatal intensive care units (n=67), intensive care units (n=87) and pediatric transport teams (n=35) prior to the survey.
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| Name | Affiliation | Role |
|---|---|---|
| Manon TAUZIN, MD | Centre hospitalier Intercommunal de Creteil | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Intercommunal de Creteil | Créteil | 94000 | France |
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| ID | Term |
|---|---|
| D001261 | Pulmonary Atelectasis |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| Immediately after the laryngoscopy |
| Numeric rating scale for pain (by operator and assistant) | Immediately after the laryngoscopy |
| TRACHEA score (Tonus, Reactivity, Awareness & Conditions of intubation to Help in Endotracheal intubation Assessment) | TRACHEA score from 0 to 10 where 0 represents adequate sedation with excellent conditions of intubation and 10 represents inadequate sedation with very poor conditions of intubation | Immediately after the laryngoscopy |
| Side effects related to the premedication | Immediately after the laryngoscopy |