Systematic review shows simulation-based training may improve first-attempt success in neonatal intubation, suggesting potential benefits for training programs.
Abstract Simulation-based training is increasingly used to address the challenges of neonatal tracheal intubation, a high-risk and infrequent procedure associated with low first-pass success and significant complications, particularly among trainees with limited opportunities for hands-on practice. This systematic review and meta-analysis aimed to synthesize current evidence on whether simulation-based training improves intubation outcomes compared with conventional or non-simulation-based approaches. Following PRISMA and Cochrane guidelines and registered with PROSPERO (CRD420251081086), reviewers searched PubMed, Cochrane CENTRAL, and Embase up to 6 June, 2025, identifying thirteen eligible randomized and prospective observational studies including 910 participants. Pooled analyses revealed that simulation-based training showed a trend toward higher first-attempt success (RR 1.10, 95% CI 0.99–1.22) and overall success rates (RR 1.04, 95% CI 0.97–1.11) compared to controls, though neither reached statistical significance. Time to intubation was slightly shorter in the simulation group but with wide confidence intervals (mean difference − 2.62 seconds, 95% CI -10.12 to 4.48). While the evidence suggests a possible benefit of simulation for achieving successful neonatal intubation on the first attempt, larger and better-standardized trials are needed to confirm its impact on clinical practice and to guide its optimal integration into neonatal airway training programs.
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Hassan et al. (2025) studied this question.
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