Holding Intubated Infants in ICU Found to Be Safe, Beneficial

Holding intubated infants in the intensive care unit is well tolerated and does not increase adverse events, according to a study published in the December issue of Critical Care Nurse.

Laura Ortmann, M.D., and Anne Dey, D.N.P., R.N., from the Children's Hospital and Medical Center Omaha in Nebraska, examined the safety of a holding intervention for infants younger than 6 months of age who were intubated for respiratory failure. In the intervention, a caretaker held the infant at least twice a day once the infant was medically stabilized. Data were examined from 24 infants with 158 holding interventions; rates of adverse events were compared to those of historical controls.

The researchers found that the mean holding duration was 99 minutes. Of the holding interventions, 20 were terminated early, mainly due to agitation. One unplanned extubation and two arterial catheter removals were recorded in the 24 historical controls. No unplanned extubations, inadvertent central catheter removals, or urinary catheter removals were reported in the intervention group, while there was one arterial catheter removal that was not associated with holding. Before and during holding, vital signs were similar. Duration of intubation, length of stay in the intensive care unit, and length of hospital stay did not differ for the control and intervention groups.

"The intervention was well received by nurses and parents and led to an unexpected increase in holding for all infant populations in our pediatric intensive care unit," the authors write.

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