LAUSR

Introduction/Hypothesis: Tracheal intubation (TI) is a high risk procedure for the pediatric population in the cardiovascular intensive care unit (CVICU). There is currently limited data on apneic oxygenation (AO) feasibility and effectiveness among children in the pediatric CVICU. We hypothesize that AO is feasible and associated with decreased TIAE and oxygen desaturation. Methods: Retrospective cohort from a large academic pediatric CVICU between 1/2015-3/2019. AO was introduced as QI in 1/2017. Pre-AO vs. Post-AO comparison for feasibility. AO effectiveness on TIAE and hypoxemia among TIs during post-AO. Results: A total of 211 patients received TI: 92 in pre-AO and 119 in post-AO. None of the TIs used AO during pre-AO phase. AO was used in 21% of TIs (25/119) during post-AO (p<0.001). Post-AO had fewer TIs with adverse TIAEs (18% in pre-AO vs. 7% in post-AO). Oxygen desaturation (≥20% saturation drop) was similar in both phases (30% in pre-AO vs. 26% in postAO, p=0.48). Among TIs in post-AO phase, the TIAE rates were not different: 6% in TI with AO vs. 8% in TI without AO, p=0.77; similarly the oxygen desaturation rates were not different: 28% with AO vs. 26% without AO, p=0.80. The use of AO was not different in children with cyanotic heart disease vs. without cyanotic heart disease (24% vs. 18%, p=0.47). Conclusions: The use of AO during post-AO implementation phase was low in a large CVICU. The impact of AO on adverse TIAEs and hypoxemia are to be determined given the low AO use. AO was used indifferently in both cyanotic and non-cyanotic heart disease.