Indications for tracheal intubation of the newborn

What are the indications for tracheal intubation of the newborn? 

Indications for tracheal intubation vary but are based on the degree of respiratory depression, the success of ventilation efforts, the presence of meconium, the degree of prematurity, and the skill of the health care provider. There is controversy at every turn. For instance, some neonatal experts feel that early intubation in infants younger than 28 weeks is indicated, and others suggest these infants can be handled with mask or nasal prong CPAP (continuous positive airway pressure). 

Endotracheal intubation is indicated if a neonate:

  • • Has not responded to assisted ventilations with a bag-mask
  • • Is extremely low birth weight
  • • Requires chest compressions
  • • Needs tracheal administration of medications
  • • Has signs of respiratory depression with meconium
  • • Has special circumstances (diaphragmatic hernia)

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