Stylet compared with no stylet for neonatal intubation

Patient or population: neonates requiring endotracheal intubation

Settings: neonatal intensive care unit or delivery room or theatre

Intervention: a stylet inserted into the endotracheal tube

Comparison: no stylet inserted into the endotracheal tube

First intubation attempt success rate

(outcome achieved at time of intubation attempt and not followed up)

RR 1.08
(0.88 to 1.32)

302
(1)

⊕⊕⊕⊝^a,b
low

Unblinded trial with no blinded outcome assessment

Single study

Gestational age of the infant

no data

no data

absence of evidence

Professional category of the intubator ‐ fellow: first intubation attempt success rate

(outcome achieved at time of intubation attempt and not followed up)

RR 0.94
(0.69 to 1.29)

74
(1)

⊕⊕⊝⊝^a,b
low

Unblinded trial with no blinded outcome assessment

Single study

Professional category of the intubator ‐ resident: first intubation attempt success rate

(outcome achieved at time of intubation attempt and not followed up)

RR 1.17
(0.90 to 1.52)

228
(1)

⊕⊕⊕⊝^a,b
low

Unblinded trial with no blinded outcome assessment

Single study

Level of experience of the intubator

no data

no data

absence of evidence

Premedication given ‐ no premedication given: first intubation attempt success rate

(outcome achieved at time of intubation attempt and not followed up)

RR 0.98
(0.72 to 1.32)

146
(1)

⊕⊕⊕⊝^a,b
low

Unblinded trial with no blinded outcome assessment

Single study

Premedication given ‐ no premedication given: first intubation attempt success rate

(outcome achieved at time of intubation attempt and not followed up)

RR 1.18
(0.89 to 1.55)

156
(1)

⊕⊕⊕⊝^a,b
low

Unblinded trial with no blinded outcome assessment

Single study

Timing of intubation ‐ just after birth in the delivery room: first intubation attempt success rate

(outcome achieved at time of intubation attempt and not followed up)

RR 0.98
(0.72 to 1.32)

146
(1)

⊕⊕⊕⊝^a,b
low

Unblinded trial with no blinded outcome assessment

Single study

Timing of intubation ‐ following admission to NICU: first intubation attempt success rate

(outcome achieved at time of intubation attempt and not followed up)

RR 1.18
(0.89 to 1.55)

156
(1)

⊕⊕⊕⊝^a,b
low

Unblinded trial with no blinded outcome assessment

Single study

Type of stylet

no data

no data

absence of evidence

Weight < 1000 g

(outcome achieved at time of intubation attempt and not followed up)

RR 0.89
(0.67 to 1.18)

152
(1)

⊕⊕⊕⊝^a,b
low

Unblinded trial with no blinded outcome assessment

Single study

*The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on assumed risk in the comparison group and relative effect of the intervention (and its 95% CI)
CI: confidence interval; RR: risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate
Very low quality: We are very uncertain about the estimate