Even for experienced paediatric anaesthetists’ tracheal intubation, in neonates, is technically challenging with repeated intubations causing trauma and increasing the risk of failure. Neonates are particularly prone to hypoxaemia, with desaturation occurring rapidly following the cessation of spontaneous or assisted respiration.
This international multicentre, prospective, single blinded, randomised control trial will recruit neonates, aged up to 52 weeks post conceptual age, requiring intubation in theatre. A total of 240 neonates, 120 assigned to either the intervention or control group, will be recruited. The intervention group will receive 1L/kg/min of oxygen delivered via nasal cannula during the apnoeic phase of tracheal intubation, while the control group will not receive supplemental oxygen during their intubation (current standard practice). The use of a VL will be standard across both groups.
This study aims to investigate the effects of apnoeic oxygenation in neonates during intubation. The primary outcome and hypothesis are that supplemental oxygenation and the standardised use of a VL, will improve the first intubation success rate reducing both desaturations (<90 per cent) and bradycardia (<100bpm) in neonates, less than 52-weeks post conceptual age.
Associate Professor Neil Hauser, Perth Children’s Hospital, Western Australia, Dr Vinicius C Quintao, University of São Paulo, Brazil, Associate Professor Arash Afshari, Copenhagen University Hospital, Denmark.
The project was awarded A$70,000 funding through the ANZCA research grants program for 2026.