Ellen de Kort

GENERAL DISCUSSION Endotracheal intubation in neonates is a frequently performed procedure that often requires multiple attempts for successful completion, 1-8 and is frequently accompanied by intubation related adverse events and severe oxygen desaturations. 1,6,9,10 This makes endotracheal intubation a high-risk procedure. Success and quality of neonatal endotracheal intubation canbe influencedbyseveral factors, including thephysiological stability and airway anatomy of the patient, the use of suitable premedication and equipment, and the experience and competency of the health care giver. 11 Patient characteristics, such as the airway anatomy, physiological stability, underlying illness and reason for intubation, cannot be changed and can only be anticipated upon. Procedure characteristics such as the use of premedication, and the experience of the health care givers performing the procedure, however, can and should be influenced to pursue optimal success and the best quality of the procedure. In this context, we are “ready to tack”. It is time for the available evidence, some of it already existing for years, to be implemented into clinical practice and to individualize the premedication strategy rather than using a population-based strategy, all to improve patient safety and to give optimal care during this high-risk procedure.