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A tiny baby intubation team improves endotracheal intubation success rate but decreases residents’ training opportunities



To assess the educational and clinical impact of a tiny baby intubation team (TBIT).

Study design

Retrospective study comparing endotracheal intubation (ETI) performed: pre-implementation of a TBIT (T1), 6 months post-implementation (T2), and 4 years post-implementation (T3).


Post-implementation (T2), first-attempt success rate in tiny babies increased (44% T1; 59% T2, p = 0.04; 56% T3, p = NS) and the proportion of ETIs performed by residents decreased (53% T1; 37% T2, p = 0.001; 45% T3, p = NS). After an educational quality improvement intervention (prioritizing non-tiny baby ETIs to residents, systematic simulation training and ETI using videolaryngoscopy), in T3 residents’ overall (67% T1; 60% T2, p = NS; 79% T3, p = 0.02) and non-tiny baby ETI success rate improved (72% T1; 60% T2, p = NS; 82% T3, p = 0.02).


A TBIT improves success rate of ETIs in ELBW infants but decreases educational exposure of residents. Educational strategies may help maintain resident procedural competency without impacting on quality of care.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.


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Authors and Affiliations



LG-A has contributed to conception and design, acquisition of data, analysis and interpretation of data. She has co-written (with MJ) the first draft of this specific article and modified subsequent drafts until all authors approved the final version of the article. MJ has contributed to conception and design, acquisition of data, analysis and interpretation of data. She has co-written (with LG-A) the first draft of this specific article and revised the article critically for important intellectual content. GE and KJB have contributed to analysis and interpretation of data; and revised the article critically for important intellectual content. TP has contributed to acquisition of data, analysis and interpretation of data; and revised the article critically for important intellectual content. AM has contributed to conception and design, acquisition of data, analysis and interpretation of data. He helped LG-A and MJ write the first draft of this specific article and revised the article critically for important intellectual content. All authors agree to be accountable for all aspects of the work. They ensure that questions relating to accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors have approved the final version of the article as sent to Journal of Perinatology.

Corresponding author

Correspondence to A. Moussa.

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Competing interests

The authors declare no competing interests.

Ethics approval

This study was approved by the Sainte-Justine University Hospital institutional review board (Reference number: 2016-1209) and performed in accordance with the Declaration of Helsinki.

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Gariépy-Assal, L., Janaillac, M., Ethier, G. et al. A tiny baby intubation team improves endotracheal intubation success rate but decreases residents’ training opportunities. J Perinatol 43, 215–219 (2023).

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