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Atropine Versus no Atropine for Neonatal Rapid Sequence Intubation

Phase 4
Conditions
Bradycardia
Hypoxemia
Interventions
Drug: Placebo
Registration Number
NCT01595399
Lead Sponsor
University of Manitoba
Brief Summary

The purpose of this study is to compare heart rate in infants who receive atropine as a part of their medication before intubation to those who do not.

To be able to find out , we need to divided babies into 2 groups;

group 1 : receives atropine + sedation + muscle relaxant group 2 : receives water or saline ( placebo group) + sedation + muscle relaxant

Then we need to compare heart rate during intubation and duration of intubation between the 2 groups.

Detailed Description

We hypothesize that premedication for intubation with fentanyl and succinylcholine alone will maintain equal stability of heart rate and oxygen saturation without a prolongation of time to completion of intubation when compared to a protocol using atropine, fentanyl and succinylcholine.

In order to answer this question we plan to undertake a prospective randomized double blinded control trial of use of atropine as an adjunct for elective intubation of infants less than 46 weeks postmenstrual age.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
70
Inclusion Criteria
  • Any infant (preterm and term) up to 46 weeks corrected age requiring (nonemergent) intubation.
  • IV access is obtained
  • Informed parental consent
Exclusion Criteria
  • Emergent intubation or need for resuscitation
  • Congenital cyanotic heart disease
  • Obvious airway abnormalities
  • History of myopathy or family history of malignant hyperthermia or known history of phosphocholinesterase deficiency

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Atropine, fentanyl and succinylcholineatropine20 mcg/kg atropine IV, 3 mcg/kg fentanyl slowly IV and 2 mg/kg succinylcholine IV.
placebo, fentanyl and succinylcholinePlaceboan equivalent volume of normal saline to atropine IV, 3 mcg/kg fentanyl slowly IV and 2 mg/kg succinylcholine IV.
Primary Outcome Measures
NameTimeMethod
Heart rate less than 80 BPM and oxygen saturation less than 80%5-6 minutes

Heart rate and transcutaneous oxygen saturation will be monitored continuously during the procedure and data will be recorded at 3 stages;

1. 2 minutes prior to intubation (after atropine or placebo dose)

2. during intubation

3. 2 minutes after intubation (once ETT secured to face)

Secondary Outcome Measures
NameTimeMethod
Duration of intubation attempts1-2 minutes
Number of intubation attempts5-6 minutes
Lowest heart rate after premedication5-6 minutes
Lowest oxygen saturation after premedication5-6 minutes
Heart rate < 100 BPM5-6 minutes
Oxygen saturation < 85%5-6 minutes

Trial Locations

Locations (1)

Health Sciences Centre

🇨🇦

Winnipeg, Manitoba, Canada

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